Myocardial Revascularization Trials Beyond the Printed Word

Mario Fulvio Luigi Gaudino, Marc Ruel, Volkmar Falk, Michael E. Farkouh, Nick Freemantle, David Glineur, Duke E. Cameron, David P. Taggart

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

This article reviews the context and evidence of recent myocardial revascularization trials that compared percutaneous coronary intervention with coronary artery bypass grafting for the treatment of left main and multivessel coronary artery disease. We develop the rationale that some of the knowledge synthesis resulting from these trials, particularly with regard to the claimed noninferiority of percutaneous coronary intervention beyond nondiabetic patients with low anatomic complexity, may have been affected by trial design, patient selection based on suitability for percutaneous coronary intervention, and end point optimization favoring percutaneous coronary intervention over coronary artery bypass grafting. We provide recommendations that include holding a circumspect interpretation of the currently available evidence, as well as suggestions for the collaborative design and conduct of future clinical trials in this and other fields.
Original languageEnglish
Pages (from-to)2943-2951
Number of pages9
JournalCirculation
Volume138
DOIs
Publication statusPublished - 2018

Keywords

  • clinical trials as topic
  • coronary artery disease
  • coronary stenosis
  • percutaneous coronary intervention
  • surgical procedures, operative
  • treatment outcomes

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