In the SYNTAX trial, 45% of screened patients with unprotected left main CAD had complex disease that pre- vented randomization; 89% of those underwent CABG.66,81 In addition, 705 of the 1800 patients with unprotected left main CAD were randomized to either DES or CABG. The major- ity of patients with left main CAD and a low SYNTAX score had isolated left main CAD or left main CAD plus 1-ves- sel CAD. The majority of those with an intermediate score had left main CAD plus 2-vessel CAD, and most of those with a high SYNTAX score had left main CAD plus 3-vessel CAD. At 1 year, rates of all-cause death and MACCE were similar among patients who had undergone DES and those who had undergone CABG.81 Repeat revascularization was performed more often in the DES group than in the CABG group (11.8% versus 6.5%), but stroke occurred more often in the CABG group (2.7% versus 0.3%). At 3 years of follow- up, the incidence of death in those undergoing left main CAD revascularization with low or intermediate SYNTAX scores (<33) was 3.7% after DES and 9.1% after CABG (P=0.03), whereas in those with a high SYNTAX score ( 33), the inci- dence of death after 3 years was 13.4% after DES and 7.6% after CABG (P=0.10).81 Because the primary endpoint of the overall SYNTAX trial was not met (ie, noninferiority com- parison of CABG and DES), the results of these subgroup analyses need to be applied with caution. At 5 years of fol- low-up, MACCE rates did not differ significantly between groups of patients with low or intermediate SYNTAX scores, but significantly more patients in the DES group with high Table 4. 