TCT 2025 - 10-year findings from NOBLE showed no safety concerns for percutaneous coronary intervention (PCI) compared to coronary artery bypass surgery (CABG) for the treatment of left main coronary artery (LMCA) disease.

Dr Evald Høj Christiansen (Aarhus University Hospital, Aarhus, DK) joins us to share the 10-year mortality findings from the NOBLE trial, investigating PCI vs CABG in LMCA disease. Patients were followed up for 10 years, and after five years, a patient level meta analysis was conducted with the EXCEL, SYNTAX LEFT MAIN, and PRECOMBAT trials.

Investigators found that the Kaplan-Meier estimate of 10-year mortality in patients with LMCA disease showed no statistical significance between the two groups, with rates of 25% in the CABG arm and 23% in the PCI arm.

Interview Questions: 
1. Could you briefly remind us of the background and design of the NOBLE trial, and why unprotected left main disease was chosen for study? 
2. Can you summarize the key 10-year mortality findings comparing PCI and CABG?
3. How should clinicians interpret these results given advances in stent technology and surgical techniques since the trial began?
4. What is your key take-home message?

Editor: Tom Green, Oliver Miles.
Video Specialist: Mirjam Boros, Yazmin Sadik.

Support: This is an independent interview produced by Transcatheter Academy.