Table 1

Summary of Large, Multicenter RCTs Comparing PCI Versus CABG in Patients Undergoing Revascularization for Complex CAD

Trial (Ref. #)DateSiteStudy PeriodPopulationNumber of PatientsInterventionsPrimary EndpointFollow-Up (yrs)Outcome
PCI (%)CABG (%)p Value
SYNTAX (27)201385 centers in the United States and Europe2005–20073-VD or LMS1,800PCI with first-generation paclitaxel-eluting stent vs. CABG (1:1 ratio)All-cause death, stroke, myocardial infarction, and repeat revascularization117.812.40.002
537.326.9<0.001
FREEDOM (28)2012140 international centers2005–2010Diabetes and multivessel coronary artery disease (3-VD or LMS)1,900PCI with sirolimus- or paclitaxel-eluting stents vs. CABG (1:1 ratio)All-cause death, nonfatal myocardial infarction, or nonfatal stroke213.011.90.005
526.618.70.005
PRECOMBAT (29)201513 centers in South Korea2005–2009LMS600PCI with sirolimus-eluting stent vs. CABG (1:1 ratio)All-cause death, myocardial infarction, stroke, or ischemia-driven target-vessel revascularization18.76.70.01
517.514.30.26
BEST (30)201527 centers in East Asia2008–2013Multivessel coronary artery disease (3-VD or LMS)880PCI with everolimus-eluting stent vs. CABG (1:1 ratio)All-cause death, myocardial infarction, or target-vessel revascularization211.07.90.32
4.6 (median)15.310.60.04
EXCEL (31)2016126 centers in 17 countries2010–2014LMS with low/intermediate SYNTAX scores1,905PCI with everolimus-eluting stent vs. CABG (1:1 ratio)All-cause death, stroke, or myocardial infarction315.414.70.98

3-VD = 3-vessel disease; BEST = Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease trial; CABG = coronary artery bypass grafting; CAD = coronary artery disease; EXCEL = Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization trial; FREEDOM = Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease trial; LMS = left main stem disease; PCI = percutaneous coronary intervention; PRECOMBAT = Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease trial; RCT = randomized controlled trial; SYNTAX = Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery trial.

  • Outcome for primary endpoint.