According to 2011 ACCF/AHA guideline and 2014 ESC/EACTS guideline, CABG surgery was
recommended for three-vessel coronary artery disease and left main coronary artery disease in
the patients with stable ischemic heart disease as class I. 2-VD with proximal left anterior
descending artery stenosis was also indicated for CABG surgery as class I recommendation.
However, many patients have been recommended for PCI by catheterization laboratory
cardiologist; 46% and 93% in the only-CABG candidates and both CABG and PCI candidates,
retrospectively, defined by previous ACC/AHA guideline. Although the discordance between real
practice in catheterization laboratory and guideline would be adjusted by recently updated
guideline. The revascularization strategy for patients with 3-VD/LMD in real practice have
been getting toward more PCI and less CABG surgery. In this study, we will identify the rate
of CABG candidates who were treated with PCI or medical treatment instead of CABG surgery in
different from current guideline. We are also going to compare two treatment strategies CABG
surgery vs. PCI with 2nd generation DES regarding clinical outcomes.