Will Localized Chronic Coronary Syndrome Guidance Shift CABG Thresholds in the Philippines?

Which stable angina features should prompt early referral for coronary angiography or Heart Team review?

Refer early for invasive assessment when angina is high-risk, refractory, or anatomy is likely to change management; do not wait for prolonged outpatient titration if symptoms occur at low workload, non-invasive testing is high-risk, or LV function is impaired. For suspected left main / multivessel disease or when reva

Why does ISCHEMIA not rule out CABG benefit in left main or complex multivessel disease?

ISCHEMIA does not rule out a CABG benefit in left main or complex multivessel coronary disease because those patients were largely not the population tested in ISCHEMIA. The trial mainly addressed patients with moderate–severe ischemia, preserved/acceptable anatomy for either strategy, and without significant left main

Which anatomic and clinical factors should outweigh symptom burden when choosing CABG over PCI?

When deciding CABG over PCI, anatomic and prognostic factors should outweigh symptom burden whenever the revascularization choice is being driven by survival, MI reduction, durability of complete revascularization, or future-event prevention, rather than simply angina relief. In practice, CABG is generally favored when

How should diabetes and reduced LVEF modify revascularization strategy in multivessel CAD?

In multivessel CAD, both diabetes and reduced LVEF shift the balance away from routine PCI-first strategies and toward CABG, especially when disease is anatomically complex, complete revascularization by PCI is unlikely, or LVEF is markedly reduced. Philippine Heart Association guidance states that CABG should be consi

What symptom-driven follow-up pathway is most practical for recurrent angina after CABG in resource-variable settings?

For recurrent angina after CABG, the most practical approach in resource-variable settings is a symptom-driven, risk-stratified pathway: 1. First decide if this is possible ACS/unstable ischemia rather than stable recurrent angina. 2. In low-resource settings, use history, CCS angina class, ECG, troponin if available,