The Particulars: Research does not clearly indicate whether stroke risk is lower for patients who undergo PCI or for those who undergo CABG.
Data Breakdown: A meta-analysis of 83 trials involving nearly 23,000 patients who underwent PCI, on-pump CABG, or off-pump CABG found significantly lower rates of 30-day stroke with PCI than with off-pump CABG (odds ratio = 0.39) or on-pump CABG (OR = 0.26). While initial results suggested that off-pump CABG was associated with significantly lower stroke rates than on-pump CABG (OR= 0.67), the difference was no longer significant after stratifying results from high-quality trials, trials with more than 100 patients, and those with a definition for Clinical Events Committee adjudication of stroke.
Take Home Pearls: PCI appears to be associated with a lower risk of stroke than either on-pump CABG or off-pump CABG. Off-pump CABG appears to be associated with a lower, but not statistically different, risk of stroke than on-pump CABG.