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DOI: 10.1055/s-0029-1191543
The SYNTAX trial – no cerebrovascular events in a German sub-analysis after 12 months of follow-up
Objectives: The SYNTAX-trial (SYNergy between Percutaneous Coronary Intervention and Cardiac Surgery) is the first randomised, controlled clinical trial to compare percutaneous coronary intervention (PCI) using a drug-eluting stent to coronary artery bypass graft (CABG) in patients with left main and three vessel disease (n=1800). A major finding to the disadvantage of the CABG-group was the significant difference in the rate of stroke (CABG 2.2% vs. PCI 0.6%; p=0.003). Therefore our single-centre sub-analysis focused on MACCE and cerebrovascular events.
Methods: Median follow-up was 27.3±5 months. Thirty Patients with left main disease or threee vessel disease were assessed by a multidisciplinary team including interventional cardiologists and cardiac surgeons and were randomised into two cohorts (PCI or CABG). Five patients were excluded because of death before treatment or withdrawal of consent. In the CABG-group (n=11) 5 patients had left main disease and in the PCI-group (n=14) 3 patients had left main disease. Univariate analysis was performed for rate of all-cause death, stroke, myocardial infarction, repeat revascularisation and MACCE-rate.
Results: Significantly more patients treated with PCI required reintervention (PCI 28.6% vs. CABG 0%, p=0.05). None of the 25 patients suffered a stroke within 12 months. One patient from the PCI-group suffered a stroke within the later follow-up period (after 23 months; p=0.36; n.s.). None of the other above mentioned parameters showed significant differences.
Conclusions: Our sub-analysis confirmed the findings of the entire SYNTAX-study population. However there were no strokes in our series within 12 months in neither of the groups.