One of your patients has discrete angiographically significant lesions in the mid right coronary artery and the mid left anterior descending coronary artery. He is 60 years old and is not diabetic. He has ongoing class 2 anginal symptoms despite optimal dose of a beta-blocker and a long-acting nitrate.
What do you recommend?
A. CABG will be associated with a greater mortality benefit compared with PCIThe benefits of revascularization and the comparison of modalities depend on the patient’s background and coronary anatomy. With this anatomy revascularization is for symptoms and not prognosis. Both modalities are equally effective in this respect. Revascularization should be considered for stable angina refractory to two oral antianginals in preference to a third agent. The risk of stroke is similar. Although PCI has the advantage of rapid recovery, the probability of repeat revascularization is statistically higher.