Treatment
Table 9. Revascularization to Improve Symptoms with
Significant Anatomic (≥50% Left Main or ≥70%
Non–Left Main CAD) or Physiological (Fractional
Flow Reserve [FFR] ≤0.80) Coronary Artery Stenoses
Clinical Setting
>1 significant stenosis amenable to revascularization and
unacceptable angina despite GDMT
>1 significant stenosis and unacceptable angina in whom
GDMT cannot be implemented because of medication
contraindications, adverse effects, or patient preferences
Previous CABG with >1 significant stenosis associated
with ischemia and unacceptable angina despite GDMT
Complex 3-vessel CAD (eg, SYNTAX score >22) with
or without involvement of the proximal LAD artery and
a good candidate for CABG
Viable ischemic myocardium that is perfused by
coronary arteries that are not amenable to grafting
No anatomic or physiological criteria for
revascularization
32
COR
1—CABG
1—PCI
IIa—CABG
IIa—PCI
IIa—PCI
IIb—CABG
IIa—CABG
preferred
over PCI
IIb—TMR as an
adjunct to
CABG
III: Harm—CABG
III: Harm—PCI
LOE
A
C
C
C
C
B
B
C
C
