In search of the "IDEAL" left main coronary stent and DAPT regimen

EuroIntervention 2022;17:1457-1459. DOI: 10.4244/EIJ-E-22-00006

Gregg Stone
Gregg W. Stone1, MD; Chandrashekar Bohra1, MD
1. The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Percutaneous coronary intervention (PCI) is being increasingly used in patients with left main coronary artery disease (LMCAD). An individual patient data pooled meta-analysis from 4 large-scale randomised trials of PCI with drug-eluting stents (DES) vs coronary artery bypass graft surgery (CABG), in 4,394 LMCAD patients, showed no significant differences in 5-year or 10-year mortality between the approaches1. PCI resulted in lower 30-day rates of stroke and large procedural myocardial infarctions (MI), but higher rates of spontaneous MI and repeat revascularisation procedures during follow-up. Formal quality-of-life studies have shown better early quality-of-life with PCI than with CABG, with comparable late outcomes after both ...

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