Table 8. Revascularization to Improve Survival Compared
with Medical Therapy (continued)
Anatomic Setting
COR
3-vessel disease with or without proximal LAD artery disease*
CABG
I
IIa—It is reasonable to choose CABG over PCI in
patients with complex 3-vessel CAD (eg, SYNTAX
score >22) who are good candidates for CABG
PCI
IIb—Of uncertain benefit
2-vessel disease with proximal LAD artery disease*
CABG
I
PCI
IIb—Of uncertain benefit
2-vessel disease without proximal LAD artery disease*
CABG
IIa—With extensive ischemia
IIb—Of uncertain benefit without extensive ischemia
PCI
IIb—Of uncertain benefit
1-vessel proximal LAD artery disease
CABG
IIa—With LIMA for long-term benefit
PCI
IIb—Of uncertain benefit
1-vessel disease without proximal LAD artery involvement
CABG
III: Harm
PCI
III: Harm
LV dysfunction
CABG
IIa—EF 35%-50%
CABG
IIb—EF <35% without significant left main CAD
PCI
Insufficient data
Survivors of sudden cardiac death with presumed ischemia-mediated VT
CABG
I
PCI
I
No anatomic or physiological criteria for revascularization
CABG
III: Harm
PCI
III: Harm
* In patients with multivessel disease who also have diabetes mellitus, it is reasonable to choose
LOE
B
B
B
B
B
B
C
B
B
B
B
B
B
B
B
C
B
B
CABG (with left internal mammary artery [LIMA]) over PCI. (IIa-B)
31
