Discussion
death, restenosis
RESTENOSIS, DISEASE PROGRESSION
The present study investigated the association between RR within 5 years of the index PCI or CABG and 10-year all-cause death, among patients with 3VD and/or LMCAD in SYNTAX trial. The main findings are:RR within 5 years did not have impact on 10-year all-cause death.Patients requiring RR had a significantly higher rate of 10-year all-cause death when their primary revascularization was with PCI compared to CABG.Overall, RR was not an independent predictor of 10-year all-cause death. However, RR with CABG was, unlike RR with PCI. The high risk of RR with CABG for 10-year all-cause death was mainly contributed by patients whose primary revascularization was with CABG (RR was a redo CABG).The SYNTAX score II 2020 was able to identify those patients who would benefit the most from either CABG or PCI.Numerous studies have demonstrated that RR has a negative impact on short- and mid-term outcomes. In patients who underwent elective primary revascularization with isolated CABG, RR with PCI had a poorer prognosis at a median follow-up of 58 months, compared with those who did not [In line with the 5-year results of SYNTAX trial [There are many possible reasons for these findings. In SYNTAX study, RRs after PCI were mainly target vessel revascularizations, and to a lesser extent treatment of de novo lesions. Disease progression and restenosis appear to be more aggressive after index revascularization with PCI than CABG [In addition, initial treatment with CABG offers complete revascularization more frequently than PCI, which may result in a greater protective effect on long-term prognosis [The impact of type of RR on mortality remains uncertain, with previous results inconsistent. A patient-level pooled analysis demonstrated that the type of RR did not affect mortality after TLR of LMCAD [At 5 years in SYNTAX trial, patients who underwent RR by PCI had a numerically higher rate of all-cause death compared to those who did not, when their initial revascularization was also by PCI (16.6% vs. 13.2%, 