5 year results of a registry comparing left main stem stenting vs. CABG in unprotected left main (MAIN-COMPARE), have been discussed. This was not randomised study like SYNTAX (1800 patients with multi-vessel disease and/or unprotected LMS).  However it included 2240 patients and propensity score matching was used to reduce the effect of treatment selection bias.

Results show that at 5 years there were similar rates of death, Q wave MI and stroke but more revascularisations in the PCI group compared to the CABG group. Stent type did not significantly affect outcomes.

We await longer term data from SYNTAX but this registry reassures further that unprotected LMS stenting is safe in selected cases.

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