Shubra El Kheima 1

Researchers are evaluating the effects of two heart procedures, percutaneous coronary intervention PCI and coronary artery bypass grafting CABG, in patients who have significant coronary artery disease affecting multiple vessels or the left main artery along with reduced heart pumping function ischemic left ventricular dysfunction. This international trial aims to determine which procedure better reduces risks like death, stroke, heart attacks, urgent repeat treatments, or heart failure hospitalizations over about five years. The study also assesses early risks and patient-reported outcomes to understand the impact of these treatments. Participants will be randomly assigned to receive either PCI or CABG. PCI uses modern techniques including drug-eluting stents, specialized imaging, and advanced methods to treat blocked arteries, while CABG surgery involves grafting arteries to bypass blockages, tailored to each patients heart condition and surgical judgment. Treatment planning is guided by a Heart Team of cardiologists and surgeons. Procedures are generally performed within two weeks after randomization, and PCI may include staged treatments within 90 days. Throughout the study, participants will be closely monitored with regular assessments over a median of five years. Researchers will track outcomes like death, stroke, heart attacks, repeat procedures, and hospitalizations. Safety and adverse events will be recorded, especially within the first 30 to 90 days after treatment. The trial will also collect patient feedback to evaluate quality of life and other health measures over time. This long-term follow-up aims to provide comprehensive data on the benefits and risks of each revascularization method.