Coronary artery bypass grafting versus percutaneous coronary intervention: a comparison of efficacy in patients with complex coronary artery disease.

Abstract

Introduction: Coronary artery disease (CAD) is one of the leading causes of death worldwide, with the most severe presentation being three-vessel disease and involvement of the left main coronary artery. In these conditions, myocardial revascularization is performed through coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Objectives: To compare the proposed intervention techniques according to adverse events, complications, the need for new interventions, and impact on quality of life to determine the most effective technique. Methodology: This study is a systematic review with a qualitative and exploratory approach. The research was conducted in the PubMed database, and the final articles were selected by two independent reviewers based on inclusion criteria involving clinical trials, adult patients diagnosed with complex coronary artery disease who required CABG or PCI interventions, published between 2015 and 2025. Conclusion: The comparison between both surgical procedures demonstrated the presence of distinct benefits that make the choice dependent on individual patient factors such as age, associated comorbidities, complexity of coronary lesions, and life expectancy. Myocardial revascularization surgery showed a reduction in complications due to protection against major cardiovascular events, less need for reinterventions, and, consequently, better long-term clinical and economic performance, especially in patients with complications. Meanwhile, PCI was advantageous in terms of periprocedural complications (stroke, infections, and atrial fibrillation), shorter hospital stays, and faster return to daily activities. Thus, both procedures proved to be effective and valid according to the patient's needs.