eng application/pdf 1219371 bytes 2022 https://unilib.phaidrabg.rs/o:3340 doi:10.1093/eurheartj/ehab537 cobiss:128898057 ISSN: 0195-668X http://creativecommons.org/licenses/by-nc/4.0/legalcode SYNTAX Extended Survival Investigators AIM: The aim of this study was to compare long-term all-cause mortality between patients receiving percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) using multiple (MAG) or single arterial grafting (SAG). METHODS AND RESULTS: The current study is a post hoc analysis of the SYNTAX Extended Survival Study, which compared PCI with CABG in patients with three-vessel (3VD) and/or left main coronary artery disease (LMCAD) and evaluated survival with >_10 years of follow-up. The primary endpoint was all-cause mortality at maximum follow-up (median 11.9 years) assessed in the as-treated population. Of the 1743 patients, 901 (51.7%) underwent PCI, 532 (30.5%) received SAG, and 310 (17.8%) had MAG. At maximum follow-up, all-cause death occurred in 305 (33.9%), 175 (32.9%), and 70 (22.6%) patients in the PCI, SAG, and MAG groups, respectively (P < 0.001). Multiple arterial grafting [adjusted hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.49–0.89], but not SAG (adjusted HR 0.83, 95% CI 0.67–1.03), was associated with significantly lower all-cause mortality compared with PCI. In patients with 3VD, both MAG (adjusted HR 0.55, 95% CI 0.37–0.81) and SAG (adjusted HR 0.68, 95% CI 0.50–0.91) were associated with significantly lower mortality than PCI, whereas in LMCAD patients, no significant differences between PCI and MAG (adjusted HR 0.90, 95% CI 0.56–1.46) or SAG (adjusted HR 1.11, 95% CI 0.81–1.53) were observed. In patients with revascularization of all three major myocardial territories, a positive correlation was observed be- tween the number of myocardial territories receiving arterial grafts and survival (Ptrend = 0.003). CONCLUSION: Our findings suggest that MAG might be the more desirable configuration for CABG to achieve lower long-term all-cause mortality than PCI in patients with 3VD and/or LMCAD. TRIAL REGISTRATION: Registered on clinicaltrial.gov. SYNTAXES: NCT03417050 (https://clinicaltrials.gov/ct2/show/NCT03417050); SYNTAX: NCT00114972 (https://www.clinicaltrials.gov/ct2/show/NCT00114972). info:eu-repo/semantics/article Key words: percutaneous coronary intervention, coronary artery bypass grafting, multiple arterial grafting, single arterial grafting Davierwala, Piroze Gao, Chao Thuijs, Daniel J.F.M. Wang, Rutao Hara, Hironori Ono, Masafumi Noack, Thilo Garg, Scot O’leary, Neil Milojević, Milan Kappetein, Arie Pieter Morice, Marie-Claude Mack, Michael J. Van Geuns, Robert-Jan Holmes Jr., David R. Gaudino, Mario Taggart, David P. Onuma, Yoshinobu Mohr, Friedrich Wilhelm Serruys, Patrick W. European heart journal 43(13) Single or multiple arterial bypass graft surgery vs. percutaneous coronary intervention in patients with three-vessel or left main coronary artery disease