Yoon YH, et al. - In this study including 2,112 patients with ostial or shaft left main coronary artery (LMCA) disease from IRIS-MAIN registry who underwent percutaneous coronary intervention (PCI) (n = 1,329) or coronary-artery bypass grafting (CABG) (n = 783), researchers compared the treatment effects of both of these treatment strategies. They stratified patients by time period based on stent type availability: wave 1 (1995–2002, bare-metal stent [BMS] era); wave 2 (2003–2006, first-generation drug-eluting stent [DES] era); and wave 3 (2007–2014, second-generation DES era). They reported a more frequent use of PCI from wave 1 to wave 3, compared to CABG. Regarding death; the composite of death, myocardial infarction (MI), or stroke; repeat revascularization; and major adverse cardiac and cerebrovascular events (MACCE; a composite of death, MI, stroke, or repeat revascularization), substantial improvements over time were seen with PCI. By contrast, relatively stable outcomes of CABG were reported over time. Overall, significant improvements noted in PCI outcomes led to a progressive decline in the gap between the outcomes of CABG and PCI in patients with ostial or shaft LMCA disease.