BCIS ACI 2020: NOBLE and SYNTAX ES studies — Dr Colum Owens


Dr Colum Owens (Royal Victoria Hospital, Belfast, UK) comments on the trial results for the NOBLE trial (Coronary Artery Bypass Grafting Vs Drug Eluting Stent Percutaneous Coronary Angioplasty in the Treatment of Unprotected Left Main Stenosis), in light of the SYNTAX Extended Survival study. He examines the results, the study design differences and highlights how both studies indicate that PCI and bypass can be considered as safe methods of intervention to treat patients with LMCA.


  1. Please summarise the NOBLE study and its key outcomes?
  2. Please summarise the SYNTAXES study and its key outcomes?
  3. What were the key differences between the studies?
  4. What are the limitations?
  5. How should these data influence patient selection for LMCA disease?
  6. Is independent ratification of the EXCEL data required to add this back into the discussion?
  7. Are further studies required to provide true clarification?

Filmed in London at BCIS ACI 2020.

Interviewer: Leiah Norcott
Videographer: Natacha Wienand / Dominic Woodruff