Nuestra verdad sobre SYNTAX

The Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) clinical trial is a milestone in the history of myocardial revascularisation. The analysis of the primary endpoint showed that surgery reduced the risk of major cardiovascular events versus percutaneous coronary intervention with coated stents in patients with multi-vessel coronary disease or left main artery disease. However, the interpretation of the subgroup analyses and secondary events has served to justify percutaneous revascularisation in selected groups of patients. The conclusions of the SYNTAX trial have had a great impact on the European guidelines on myocardial revascularisation and daily clinical practice, obliging new indications, encouraging Heart Team meetings, and making new tools like the SYNTAX score for everyday use. Cardiac surgeons and cardiologists have taken all these changes with little criticism. But how much irrefutable truth is there in SYNTAX?