24
Patients With Complex Disease
COR LOE
Recommendations
1 B-R 1. In patients who require revascularization for significant left
main CAD with high-complexity CAD, it is recommended to
choose CABG over PCI to improve survival.
2a B-R 2. In patients who require revascularization for multivessel CAD
with complex or diffuse CAD (e.g., SYNTAX score >33), it
is reasonable to choose CABG over PCI to confer a survival
advantage.
Situations in Which PCI or CABG Would Be Preferred
Revascularization to Reduce Cardiovascular Events in SIHD
Compared With Medical Therapy
COR LOE
Recommendation
Multivessel CAD
2a B-R 1. In patients with SIHD and multivessel CAD appropriate for
either CABG or PCI, revascularization is reasonable to lower
the risk of cardiovascular events such as spontaneous MI,
unplanned urgent revascularizations, or cardiac death.
Revascularization to Improve Symptoms
COR LOE
Recommendations
1 A 1. In patients with refractory angina despite medical therapy
and with significant coronary artery stenoses amenable
to revascularization, revascularization is recommended to
improve symptoms.
3: Harm C-LD 2. In patients with angina but no anatomic or physiological
criteria for revascularization, neither CABG nor PCI should
be performed.
Treatment
