†These authors contributed equally.
Academic Editors: Peter A. McCullough and Federico Ronco
Background: Personalized prognosis plays a vital role in
deciding between percutaneous coronary intervention (PCI) and coronary artery
bypass grafting (CABG) in patients with three-vessel disease (3VD). The aim of
this study is to compare the modality of revascularization chosen by the local
heart team to that recommended by using individualized predictions of medium, and
long-term all-cause mortality amongst patients with 3VD screened in the
Multivessel TALENT trial. Methods: The SYNTAX score II (SS-II)
and SS-2020 were evaluated in 200 consecutive patients by a core laboratory and
compared to the decision of the “on site” heart team. Results: According to the SS-II, CABG was the recommended treatment in 51 patients
(25.5%) however 34 (66.6%) of them received PCI. According to SS-2020 the
predicted absolute risk differences (ARD) between PCI and CABG were significantly
higher in patients receiving CABG compared to those treated by PCI for major
adverse cardiovascular and cerebrovascular events, a composite of all-cause
mortality, stroke or myocardial infarction at 5-years (8.8