Results of the Syntax Trial from the Viewpoint of the Cardiac Surgeon

pp. 518-520

Abstract

The SYNTAX trial (SYNergy between Percutaneous Coronary Intervention with TAXus and Cardiac Surgery) was performed on previously untreated patients with three-vessel or left main coronary artery disease. A total of 1800 patients with three-vessel or left main coronary artery disease were randomly assigned to coronary artery bypass graft surgery (CABGS) or percutaneous coronary intervention (PCI) in a 1:1 ratio. The combined primary end point included death, cardiac or cerebrovascular events, or repeat revascularization (MACCE=major adverse cardiac and cerebrovascular event). Coronary artery bypass graft surgery was superior to PCI. Rate of MACCE at 12 months was 17.8% in the PCI group versus 12.1% for CABGS (p=0.0015). This figures increased at 2 years in the groups of higher risk. In high-risk patients, the rate of MACCE was 15.4% versus 28.2% in the PCI group (p<0.001). In this setting, death of any cause was 5.9% in the PCI group and 3.3% in the CABGS group (p<0.008). Patients undergoing PCI had a greater incidence of cardiovascular events. It is important to wait for the conclusions after 5 years of follow-up.