o:3340 Single or multiple arterial bypass graft surgery vs. percutaneous coronary intervention in patients with three-vessel or left main coronary artery disease en 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). Key words: percutaneous coronary intervention, coronary artery bypass grafting, multiple arterial grafting, single arterial grafting 91552100 128898057 1552101 0195-668X 1552099 10.1093/eurheartj/ehab537 2023-11-24T17:00:58.710Z 44 yes 46 Piroze Davierwala 106454537 2022 46 Chao Gao 46 Daniel J.F.M. Thuijs 46 Rutao Wang 46 Hironori Hara 46 Masafumi Ono 46 Thilo Noack 46 Scot Garg 46 Neil O’leary 46 Milan Milojević 106163721 0000-0003-0984-9011 2022 46 Arie Pieter Kappetein 46 Marie-Claude Morice 46 Michael J. Mack 46 Robert-Jan Van Geuns 46 David R. Holmes Jr. 46 Mario Gaudino 46 David P. Taggart 46 Yoshinobu Onuma 46 Friedrich Wilhelm Mohr 46 Patrick W. Serruys 46 SYNTAX Extended Survival Investigators institution application/pdf 1219371 https://unilib.phaidrabg.rs/o:3340 no yes 17 70 616.1-089 92000001 71A11 European heart journal 43 13 1334 1344 2022