Long‐term clinical outcomes of coronary artery bypass graft surgery compared to those of percutaneous coronary intervention with second generation drug eluting stents in patients with stable angina and an isolated lesion in the proximal left anterior descending artery

Objectives We compared the long‐term outcomes of percutaneous coronary intervention with second‐generation drug‐eluting stents (PCI‐DES) and coronary artery bypass graft surgery (CABG) with the left internal mammary artery in stable angina patients with isolated single‐vessel proximal left anterior descending artery (pLAD) disease. Background Long‐term outcomes of second‐generation PCI‐DES and CABG in isolated pLAD lesions have not been extensively studied. Methods We included 631 PCI‐DES patients and 379 CABG patients. Unadjusted and adjusted hazard ratios (HRs) were derived for major adverse cardiac events (MACEs), their components (cardiac death, nonfatal myocardial infarction [MI] not attributed to a non‐target vessel, target‐lesion revascularization), and patient‐related outcome (PRO, composed of all‐cause mortality, any MI, any revascularization). Results In the unadjusted and adjusted analyses, no significant difference was observed between the two groups at follow‐up (mean:4.6 ± 2.5 years) for MACEs (HR: 1.45, 95% CI: 0.92–2.28, p = .11; HR:1.43, 95% CI: 0.91–2.26, p = .13), PRO (HR: 1.18, 95%CI: 0.86–1.61, p = .30; HR: 1.18, 95% CI: 0.86–1.62, p = .31), cardiac death (HR: 0.97, 95% CI: 0.46–2.05, p = .93; HR: 0.79, 95% CI: 0.36–1.72, p = .56) and MI (HR: 1.43, 95% CI: 0.49–4.13, p = .51; HR: 1.57, 95% CI: 0.53–4.64, p = .42). Compared with CABG, PCI‐DES had a borderline significantly greater risk of repeat revascularization (HR: 1.99, 95% CI: 1.00–3.94, p = .05; HR: 1.95, 95% CI: 0.98–3.9, p = .06). Angina recurred more often after PCI (p