Early Outcomes of Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Patients with Intermediate SYNTAX II Score

Background Navigating the treatment landscape for those whose SYNTAX II scores reside in the transitional band of 23 to 32 (the intermediate score zone) continues to present a formidable clinical dilemma, with the therapeutic arsenal offering divergent paths: the surgical undertaking of coronary artery bypass grafting (CABG), the catheter-based strategy of percutaneous coronary intervention (PCI), or the non-interventional realm of medical therapy. Aim To evaluate the frequency of major adverse cardiac or cerebrovascular events (MACCE) during the in-hospital period following re-vascularization procedures in participants graded as intermediate SYNTAX II scores. Methods A retrospective study was conducted at the National Heart Institute to analyze revascularization outcomes in 200 patients with intermediate SYNTAX II coronary artery disease (CAD). One hundred patients underwent CABG (coronary artery bypass grafting), and 100 patients received PCI(percutaneous coronary intervention). In-hospital MACCE was the primary endpoint. Results Two hundred patients (84% male, mean age 62.1 years) with intermediate SYNTAX II scores (mean 27.4) and significant comorbidities (diabetes 43.5%, hypertension 49%, smoking 56.5%, CKD 8.5%) undergoing revascularization (100 CABG, 100 PCI) were studied. The CABG group (mean age 61.0 years, longer bypass/cross-clamp times) had a more advanced NYHA class. The overall in-hospital MACCE rate was 4% (stroke 1%, MI 2%, mortality 3%). Conclusion This study found that the in-hospital rate of MACCE was similar for patients with intermediate SYNTAX II scores treated with CABG or PCI.