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Mortality lower after coronary bypass surgery than after percutaneous interventions

Journal
JAMA Internal Medicine
Reuters Health - 21/10/2020 - All-cause and noncardiac mortality are lower among patients who undergo coronary-artery bypass grafting (CABG) than among those who undergo percutaneous coronary intervention (PCI), according to a meta-analysis. "Randomized clinical trials must be carefully designed and provide information as accurate as possible for important patient outcomes," Dr. Mario Gaudino of Weill Cornell Medicine, in New York City, told Reuters Health by email. "Cause-specific mortality may be conceptually appealing, but is open to adjudication errors and bias, as shown in my analysis - all-cause mortality is much more reliable and should be used." Numerous clinical trials over the past three decades have compared PCI and CABG outcomes, but they have been underpowered to detect differences in mortality and all have used a composite of major adverse cardiac or cardiovascular events as their primary outcome. The ongoing EXCEL trial, however, reported signi...


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