Level 2: Mid-level evidence
The relative benefits of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) continue to be actively debated and analyzed. A recent meta-analysis of individual data from 7,812 patients in 10 randomized trials suggests that CABG may be associated with lower mortality in certain populations (Lancet. 2009;373:1190-1197). There was no difference in overall mortality comparing CABG vs. PCI (15% vs. 16%), but mortality was significantly lower for CABG among 1,233 patients with diabetes (23% vs. 29%, P =.05, NNT 17) and among 2,688 patients older than 65 years (20% vs. 24%, P =.05, NNT 25). There were no differences in mortality among younger patient populations. CABG was also associated with lower rates of angina at one year and lower rates of repeat revascularization. All trials used either balloon angioplasty or bare-metal stents for PCI.