What are the benefits of CABG over medical therapy for patients with left main CAD?
CABG confers a survival benefit over medical therapy in patients with left main CAD. Subgroup analyses from RCTs performed 3 decades ago included 91 patients with left main CAD in the Veterans Administration Cooperative Study. A meta-analysis of these trials demonstrated a 66% reduction in RR of death with CABG, with the benefit extending to 10 years. The CASS Registry contained data from 1484 patients with $50% diameter stenosis left main CAD initially treated surgically or nonsurgically. Median survival duration was 13.3 years in the surgical group and 6.6 years in the medical group.