ABSTRACT
Key issues • Which patients are most likely to benefit from coronary artery bypass grafts? • Which patients are most likely to die or suffer major morbidity from coronary artery bypass graft) • Specific subsets that could perhaps be excluded from the traditional anatomical approach: acute myocardial infarction and post-coronary artery bypass graft • Which patients are most likely to benefit from percutaneous coronary intervention? • Coronary anatomical features • The revascularization paradox: from anatomical to clinical components of risk • Patients likely to benefit from revascularization (medically refractory myocardial ischemia) are increasingly ‘high risk’ • Summary
KEY ISSUES
• Traditionally, the choice between coronary artery bypass graft (CABG) surgery and medical therapy has been made largely based upon coronary artery anatomy. Based upon < 5000 randomly allocated patients from three trials of stable angina and two trials of unstable patients, patients with left main disease and threevessel disease (especially with mild/moderate left ventricular systolic dysfunction) have been largely directed to CABG.
