6/29/23, 11:57 PM SYNTAX Pathway Feedback Search Clinical Topics Home Studies SYNTAX SYNTAX Disease Coronary artery disease Trial question Is PCI noninferior to CABG in patients with three-vessel or left main coronary artery disease? Study design Multi-center Open label RCT Population Characteristics of study participants 22.0% female N = 1800 78.0% male 1800 patients (402 female, 1398 male) Inclusion criteria: patients with three-vessel or left main coronary artery disease Key exclusion criteria: age < 21 years, previous PCI or CABG, pregnancy, ongoing acute MI, psychiatric illness or organic brain damage, single or 2-vessel disease without LM disease, or planned need for concomitant other cardiac surgery Interventions N=903 PCI (revascularization involving Taxus Express paclitaxel-eluting stents) N=897 CABG (standard contemporary techniques) Primary outcome Major adverse cardiac or cerebrovascular events at 12 months https://web.pathway.md/studies/recAMMmA1n2MbZ4cl 1/2 6/29/23, 11:57 PM SYNTAX Pathway 17.8 % 17.8 13.4 % 12.4 8.9 % Difference exceeding nonferiority margin 4.5 % 0.0 % Percutaneous coronary intervention Coronary artery bypass graft Difference exceeding nonferiority margin in major adverse cardiac or cerebrovascular events at 12 months (17.8% vs. 12.4%; RR 1.44, 95% CI 1.15 to 1.81) Secondary outcomes Significant increase in repeat revascularization (13.5% vs. 5.9%; RR 2.29, 95% CI 1.67 to 3.14) Significant decrease in stroke (0.6% vs. 2.2%; RR 0.25, 95% CI 0.09 to 0.67) No significant difference in death (4.4% vs. 3.5%; RR 1.24, 95% CI 0.78 to 1.98) Conclusion In patients with three-vessel or left main coronary artery disease, PCI was not noninferior to CABG with respect to major adverse cardiac or cerebrovascular events at 12 months. Reference Serruys PW, Morice MC, Kappetein AP et al. Percutaneous coronary intervention versus coronary- artery bypass grafting for severe coronary artery disease. N Engl J Med. 2009 Mar 5;360(10):961- 72. Open reference URL https://web.pathway.md/studies/recAMMmA1n2MbZ4cl 2/2