Publication:

Cardiovascular events related to the treated coronary artery after surgical or percutaneous revascularization in patients with stable multivessel coronary artery disease: long-term comparison with medical treatment

Background Myocardial revascularization via coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) is central for complex coronary artery disease (CAD). However, post-procedural adverse cardiovascular events remain challenging. Traditional efficacy assessments use composite endpoints, such as major adverse cardiovascular events (MACE), which include events unrelated to the treated artery, potentially compromising the evaluation of the intervention's true clinical impact. Objectives were to compare adverse cardiovascular events-nonfatal myocardial infarction and cardiac death-directly attributable to the artery treated by CABG or PCI, versus patients with similar CAD managed exclusively with medical therapy.

Methods This comparative study includes patients with stable multivessel CAD undergoing CABG, PCI, or medical therapy alone. Only clinical events anatomically linked to the treated artery (or the target vessel in the medical therapy cohort) will be analyzed. This methodology aims to deliver a precise evaluation of the technical and clinical efficacy of each revascularization strategy.

Results Data collection and statistical analysis are ongoing. The upcoming results will detail and compare the precise incidences of vessel-related myocardial infarction and cardiac death across the three therapeutic groups.

Conclusions By prioritizing vessel-specific outcomes over traditional composite endpoints, this study addresses existing methodological limitations. It offers an accurate assessment of PCI and CABG efficacy in real-world clinical practice, aiming to guide individualized, evidence-based therapeutic decisions for stable CAD management.