This document discusses strategies for diagnosing and treating stable coronary artery disease (CAD), including revascularization options of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). It states that revascularization more effectively relieves angina, reduces medication usage, and improves quality of life compared to medical therapy alone. It also notes that guidelines recommend medical treatment prior to and along with revascularization. The document provides indications and considerations for revascularization and addresses strategies for non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI) patients.

2. Strategies for Diagnosis: Functional
testing & Imaging

3. Revascularization for stable CAD
• Angina is associated with impaired quality of
life, reduced physical endurance, mental
depression, and recurrent hospitalizations and
outpatient visits
• Revascularization by PCI or CABG:
more effectively relieves angina
reduces the use of anti-angina drugs, and
improves exercise capacity and quality of life,
compared with a strategy of medical therapy
alone

4. • Prior to revascularization, patients with SCAD
must receive guideline-recommended medical
treatment, due to its established benefits in
terms of prognosis and symptom relief
• Revascularization and medical therapy should
be seen as complementary, rather than
competitive treatment strategies.

5. Indications for revascularization

6. PCI or CABG?

8. Revascularization in NSTEMI

10. • Timing of angiography and revascularization should be
based on patient risk profile
 Very high risk Pts: Urgent angiography < 2 hrs
 High Risk: Early invasive strategy within 24 hrs
 In lower-risk subsets, with aGRACE risk score of ,140 but
with at least one secondary high-risk criterion:
invasive evaluation can be delayed without increased risk but
should be performed during the same hospital stay, preferably
within 72 hours of admission.
 In other low-risk patients without recurrent symptoms:
noninvasive assessment of inducible ischaemia should be
performed before hospital discharge. 7.3 Type of
revascularization

11. Revascularization in STEMI

23. Algorithm for treatment of
cardiogenic shock

28. Revascularization in DM

30. Revascularization in CKD

32. Carotid artery screening before CABG