A systematic review and meta-analysis looked at 10,594 patients with multivessel coronary disease and multiple long-term conditions. The study compared Coronary Artery Bypass Grafting (CABG) to Percutaneous Coronary Intervention (PCI) to see which treatment worked better for specific groups.
For patients who also had diabetes and chronic kidney disease (CKD), CABG was associated with a lower risk of all-cause death and a lower risk of needing repeat revascularization compared to PCI. Patients with diabetes also reported better outcomes following CABG. However, the study found no significant difference between the two treatments regarding heart attacks or strokes. These results were consistent regardless of the patient's age or sex.
It is important to note that the evidence for these findings is generally low to very low, except for patients with diabetes where the certainty was moderate. The study also had limitations, such as not having data on frailty or peripheral vascular disease. Because these results come from a meta-analysis of existing trials, they should be discussed with a doctor to determine the best treatment plan for a specific medical situation.
