Current Treatment Strategy of Patients With Multivessel Disease or Left Main Coronary Artery Disease Indicated for Coronary Artery Bypass Graft Surgery
Current Treatment Strategy of Patients With Multivessel Disease or Left Main Coronary Artery Disease Indicated for Coronary Artery Bypass Graft Surgery
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.
Inclusion Criteria:

 -  Patients ≥ 19 years old

 -  Left main disease, three-vessel disease or two-vessel disease with proximal LAD
 stenosis.

 Exclusion Criteria:

 -  Previous PCI within 1 year

 -  Previous sternotomy

 -  Primary PCI for STEMI

 -  Contraindication or hypersensitivity to anti-platelet medications or contrast media

 -  Planned need for concomitant other cardiac surgery (eg, valve surgery or resection of
 aortic or left ventricular aneurysm, etc)

 -  Pregnant women or women with potential childbearing

 -  Inability to follow the patient over the period of 1 year after enrollment, as
 assessed by the investigator

 -  Inability to understand or read the informed content