- Question
- Is percutaneous coronary intervention (PCI) with everolimus-eluting stents noninferior to coronary artery bypass grafting (CABG) in patients with multivessel coronary artery disease?
- Design
- Randomized noninferiority trial at 27 centers in East Asia. It planned to enroll 1776 patients but was terminated early because of slow enrollment, with 880 randomized (438 to PCI and 442 to CABG). Median longer-term follow-up was 4.6 years.
- Population
- Patients with multivessel coronary artery disease.
- Intervention
- PCI with everolimus-eluting stents.
- Control
- Coronary artery bypass grafting (CABG).
- Primary outcome
- Composite of death, myocardial infarction, or target-vessel revascularization at 2 years after randomization.
- Results
- At 2 years the primary end point occurred in 11.0% with PCI and 7.9% with CABG (absolute risk difference 3.1 percentage points; 95% CI -0.8 to 6.9; P=0.32 for noninferiority), so noninferiority was not shown. At median follow-up of 4.6 years, it occurred in 15.3% vs 10.6% (HR 1.47; 95% CI 1.01 to 2.13; P=0.04).
- Safety
- There were no significant differences in the composite safety end point of death, myocardial infarction, or stroke. Any repeat revascularization and spontaneous myocardial infarction were significantly more frequent after PCI than after CABG.
- Conclusion
- In patients with multivessel coronary artery disease, PCI with everolimus-eluting stents was associated with a higher rate of major adverse cardiovascular events than CABG.
- Why it matters
- It provided evidence using second-generation drug-eluting stents in the comparison of PCI with surgery and reinforced CABG as a revascularization option in multivessel disease, with the limitation of having been stopped earlier than planned.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026