[评论] 左主干冠状动脉疾病：血运重建策略选择PCI还是CABG
摘要
临床指南通常倾向于将冠状动脉旁路移植术（CABG）而非经皮冠状动脉介入治疗（PCI）作为左主干冠状动脉疾病患者的首选血运重建策略。1–2 一项比较PCI与CABG的四项随机对照试验的个体患者水平荟萃分析提示，PCI与5年全因死亡风险显著升高无关。3 PRECOMBAT试验4和SYNTAX扩展生存试验5同样显示，接受第一代药物洗脱支架PCI的患者与接受CABG的患者在10年全因死亡率方面无显著差异。
English
Clinical guidelines generally favour coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI) as the revascularisation strategy of choice in patients with left main coronary artery disease.1–2 An individual patient-level meta-analysis of four randomised controlled trials comparing PCI with CABG has suggested that PCI was not associated with a significantly higher risk of all-cause mortality at 5 years.3 The PRECOMBAT trial4 and SYNTAX Extended Survival trial5 similarly demonstrated no significant differences in all-cause mortality at 10 years between patients who underwent PCI with first-generation drug-eluting stents and those who underwent CABG.