Department of Cardiac Surgery, Heart Center, University of Leipzig, Struempellstraße 39, 04289, Leipzig, Germany,
Curr Atheroscler Rep. 2014 Dec;16(12):461. doi: 10.1007/s11883-014-0461-x.
New-generation stents have been continually developed in order to improve the safety and efficacy of percutaneous coronary intervention (PCI). Several randomized clinical trials have been conducted over the last two decades to compare the outcomes of PCI with coronary artery bypass grafting (CABG), which has been the time-tested treatment of multivessel coronary artery disease. The Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial is one of the most recent and largest randomized controlled trials comparing PCI using the paclitaxel-eluting first-generation stent with CABG and was uniquely formulated to represent "real world" daily practice. The final 5-year main results of this trial and its various prespecified subgroups have been published in the past year. These results will form the basis of the new guidelines that will be published in the near future. This review is a compilation of the results of the SYNTAX trial and comparisons with other contemporary trials, meta-analyses, and retrospective studies of large registries and how these results help cardiac surgeons and cardiologists in judicious decision-making for their patients with multivessel coronary artery disease requiring revascularization.
新一代支架不断被开发出来，以提高经皮冠状动脉介入治疗（PCI）的安全性和疗效。在过去的二十年中，进行了几项随机临床试验，以比较 PCI 与冠状动脉旁路移植术（CABG）的结果，CABG 一直是多支冠状动脉疾病的经过时间考验的治疗方法。经皮冠状动脉介入治疗与紫杉醇心脏手术（SYNTAX）试验是最近和最大的比较 PCI 使用紫杉醇洗脱第一代支架与 CABG 的随机对照试验之一，其独特的设计代表了“真实世界”的日常实践。该试验的最终 5 年主要结果及其各种预先指定的亚组已在过去一年中公布。这些结果将构成即将发布的新指南的基础。这篇综述是对 SYNTAX 试验结果的汇编，并与其他当代试验、荟萃分析以及大型注册研究的回顾性研究进行了比较，以及这些结果如何帮助心脏外科医生和心脏病专家为需要血运重建的多支冠状动脉疾病患者做出明智的决策。
