{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T10:40:51Z","timestamp":1764240051301,"version":"3.37.3"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T00:00:00Z","timestamp":1489536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Recent trials comparing PCI with CABG for unprotected left main disease yielded discrepant evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To perform an updated meta\u2010analysis of randomized trials comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) in patients with unprotected left main coronary artery disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Randomized trials comparing PCI versus CABG for patients with unprotected left main coronary artery disease were included. Summary estimates risk ratios (RRs) were performed with a DerSimonian and Laird model at short\u2010term, intermediate and long\u2010term follow\u2010up periods (i.e., 30\u2010days, 1\u2010year, and &gt;1\u2010year). Outcomes evaluated were major adverse cardiac and cerebrovascular events (MACCE), all\u2010cause mortality, myocardial infarction, stroke, revascularization and stent thrombosis or symptomatic graft occlusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six trials with 4,700 patients and a mean SYNTAX score of 23 were included. At short\u2010term follow\u2010up, the risk of MACCE was lower with PCI (RR 0.55, 95% confidence interval [CI] 0.39\u20100.76) driven by the lower risk of myocardial infarction (RR 0.67, 95% CI 0.46\u20100.99), and stroke (RR 0.38, 95% CI 0.16\u20100.90). The risk of MACCE was similar at the intermediate follow\u2010up (RR 1.21, 95% CI 0.97\u20101.51). At long\u2010term follow\u2010up, PCI was associated with a higher risk of MACCE (RR 1.19, 95% CI 1.01\u20101.41), due to a higher risk of revascularization (RR 1.62, 95% CI 1.34\u20101.94), while the risk of all\u2010cause mortality, myocardial infarction, and stroke were similar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with unprotected left main coronary disease and low to intermediate SYNTAX score, PCI might be an acceptable alternative to CABG. \u00a9 2017 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26970","type":"journal-article","created":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T12:43:14Z","timestamp":1489581794000},"page":"541-552","source":"Crossref","is-referenced-by-count":7,"title":["Percutaneous coronary intervention or coronary artery bypass grafting for unprotected left main coronary artery disease"],"prefix":"10.1002","volume":"90","author":[{"given":"Ahmed 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