TABLE 1.
Comparison of the Clinical Endpoints in the CABG Group Compared With the PCI Group for SIHD Patients With LM or 3VD From the SYNTAX Trial (4–8)
| Patient Groups | Endpoint | 1-Year Follow-Up | 3-Year Follow-Up | 5-Year Follow-Up |
|---|---|---|---|---|
| Overall study population | MACCE | 12.4% vs. 17.8%, p = 0.002 | 20.2% vs. 28.0%, p < 0.001 | 26.9% vs. 37.3%, p < 0.0001 |
| Death from any cause | 3.5% vs. 4.4%, p = 0.37 | 6.7% vs. 8.6%, p = 0.13 | 11.4% vs. 13.9%, p = 0.10 | |
| MI | 3.3% vs. 4.8%, p = 0.11 | 3.6% vs. 7.1%, p = 0.002 | 3.8% vs. 9.7%, p < 0.0001 | |
| Stroke | 2.2% vs. 0.6%, p = 0.003 | 3.4% vs. 2.0%, p = 0.07 | 3.7% vs. 2.4%, p = 0.09 | |
| Repeat revascularization | 5.9% vs. 13.5%, p < 0.001 | 10.7% vs. 19.7%, p < 0.001 | 13.7% vs. 25.9%, p < 0.0001 | |
| CEA (ICER/QALY gained) | PCI dominant (in-trial period) | – | $12,329/QALY gained (lifetime) | |
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| Patients with a low SYNTAX score* | MACCE | 14.7% vs. 13.6%, p = 0.71 | 22.7% vs. 22.5%, p = 0.98 | 28.6% vs. 32.1%, p = 0.43 |
| Death from any cause | – | – | 10.1% vs. 8.9%, p = 0.64 | |
| MI | – | – | 4.2% vs. 7.8%, p = 0.11 | |
| Stroke | – | – | 4.0% vs. 1.8%, p = 0.11 | |
| Repeat revascularization | – | – | 16.9% vs. 23.0%, p = 0.056 | |
| CEA (ICER/QALY gained) | PCI dominant (in-trial period) | – | PCI dominant (life-time) | |
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| Patients with an intermediate SYNTAX score* | MACCE | 12.0% vs. 16.7%, p = 0.10 | 18.9% vs. 27.4%, p = 0.02 | 25.8% vs. 36.0%, p = 0.008 |
| Death from any cause | – | – | 12.7% vs. 13.8%, p = 0.68 | |
| MI | – | 3.2% vs. 7.6%, p = 0.02 | 3.6% vs. 11.2%, p = 0.0009 | |
| Stroke | – | – | 3.6% vs. 2.0%, p = 0.25 | |
| Repeat revascularization | – | 10.1% vs. 17.4%, p = 0.01 | 12.7% vs. 24.1%, p = 0.0005 | |
| CEA (ICER/QALY gained) | PCI dominant (in-trial period) | – | $36,790/QALY gained (lifetime) | |
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| Patients with a high SYNTAX score* | MACCE | 10.9% vs. 23.4%, p < 0.001 | 19.5% vs. 34.1%, p < 0.001 | 26.8% vs. 44.0%, p < 0.0001 |
| Death from any cause | – | – | 11.4% vs. 19.2%, p = 0.005 | |
| MI | – | – | 3.9% vs. 10.1%, p = 0.004 | |
| Stroke | – | – | 3.7% vs. 3.5%, p = 0.80 | |
| Repeat revascularization | – | – | 12.1% vs. 30.9%, p < 0.0001 | |
| CEA (ICER/QALY gained) | $43,486/QALY gained (in-trial) | – | $8,219/QALY gained (lifetime) | |
*
SYNTAX score: low (≤22), intermediate (23 to 32), high (≥33).
CABG = coronary artery bypass grafting; CEA = cost-effectiveness analysis; ICER = incremental cost-effectiveness ratio; LM = left main artery; MACCE = major adverse cardiac and cerebrovascular events (composite of death from any cause, MI, stroke, or repeat revascularization); MI = myocardial infarction; PCI = percutaneous coronary intervention; QALY = quality-adjusted life years; SIHD = stable ischemic heart disease; 3VD = 3-vessel disease.