6/27/23, 11:43 PM BEST Pathway Feedback Search Clinical Topics Home Studies BEST BEST Disease Coronary artery disease Trial question What is the role of everolimus-eluting stents in patients with multivessel coronary artery disease? Study design Multi-center Open label RCT Population Characteristics of study participants 29.0% female N = 880 71.0% male 880 patients (251 female, 629 male) Inclusion criteria: patients with multivessel coronary artery disease Key exclusion criteria: known hypersensitivity to heparin, aspirin, clopidogrel, everolimus, stainless steel and/or contrast media; severe congestive HF; previous bypass surgery; acute STEMI; abnormal CK; prior history of significant bleeding; contraindication to either CABG or PCI/DES; suspected pregnancy; or left main coronary artery stenosis 50% diameter Interventions N=438 PCI (with everolimus-eluting stents) N=442 CABG (standard surgical procedure) Primary outcome Death, myocardial infarction, or target-vessel revascularization 15.3 % 15.3 https://web.pathway.md/studies/recTjVFCb0Fn2Qiy6 1/2 6/27/23, 11:43 PM BEST Pathway 11.5 % 10.6 7.7 % Difference exceeding nonferiority margin 3.8 % 0.0 % Percutaneous coronary intervention Coronary artery bypass graft Difference exceeding nonferiority margin in death, myocardial infarction, or target-vessel revascularization (15.3% vs. 10.6%; HR 1.47, 95% CI 1.01 to 2.13) Secondary outcomes No significant difference in myocardial infarction (4.8% vs. 2.7%; HR 1.76, 95% CI 0.87 to 3.58) Significant increase in death, myocardial infarction, stroke, or repeat revascularization (19.9% vs. 13.3%; HR 1.54, 95% CI 1.11 to 2.14) No significant difference in death from any cause (6.6% vs. 5%; HR 1.34, 95% CI 0.77 to 2.34) Safety outcomes No significant difference in fatal bleeding. Significant difference in major bleeding (6.8% vs. 29.9%). Conclusion In patients with multivessel coronary artery disease, PCI was not noninferior to CABG with respect to death, myocardial infarction, or target-vessel revascularization. Reference Park SJ, Ahn JM, Kim YH et al. Trial of everolimus-eluting stents or bypass surgery for coronary disease. N Engl J Med. 2015 Mar 26;372(13):1204-12. Open reference URL https://web.pathway.md/studies/recTjVFCb0Fn2Qiy6 2/2