The SYNergy between Percutaneous Coronary Intervention and Cardiac Surgery (SYNTAX) Study. 

Read the "surgeon's point of view" report below:

The strengths of the SYNTAX Study are its inclusive design which relies more on clinical judgement then lists of inclusion /exclusion criteria for patient eligibility, and the high quality of care the patients received after randomization to either PCI or CABG for left main or 3 vessel CAD management.

Unfortunately the study was underpowered and did not provide a definitive result for the primary outcome, which was non inferiority of PCI. A higher rate of repeat revascularization for PCI than CABG was the reason for the negative result. This result leaves unresolved the appropriateness of use of PCI in patients with LM disease who might be willing to accept the risk of a second PCI to avoid the more invasive CABG. Longer follow up is needed to define the true difference between these two revascularization strategies.