Table 4

Recommendations for CAD Revascularization to Improve Survival

2012 Recommendation2014 Focused Update RecommendationsComments
Class IIa
  • 1. CABG is probably recommended in preference to PCI to improve survival in patients with multivessel CAD and diabetes mellitus, particularly if a LIMA graft can be anastomosed to the LAD artery (58–65). (Level of Evidence: B)

Class I
  • 1. A Heart Team approach to revascularization is recommended in patients with diabetes mellitus and complex multivessel CAD (66). (Level of Evidence: C)

  • 2. CABG is generally recommended in preference to PCI to improve survival in patients with diabetes mellitus and multivessel CAD for which revascularization is likely to improve survival (3-vessel CAD or complex 2-vessel CAD involving the proximal LAD), particularly if a LIMA graft can be anastomosed to the LAD artery, provided the patient is a good candidate for surgery (58,61–65,59–69). (Level of Evidence: B)

New recommendation
Modified recommendation (Class of Recommendation changed from IIa to I, wording modified, additional RCT added).

CABG indicates coronary artery bypass graft; CAD, coronary artery disease; LAD, left anterior descending; LIMA, left internal mammary artery; PCI, percutaneous coronary intervention; and RCT, randomized controlled trial.