Overview of randomised trials of percutaneous coronary intervention: Comparison with medical and surgical therapy

Coronary artery disease remains among the top most causes of morbidity and mortality globally. There have been substantial improvements in medical therapy to prevent and treat coronary artery disease. Treatment of coronary artery disease, both medically and invasively, has seen marked improvements in the last few decades. Development of surgical revascularisation techniques in the latter half of the 20th century revolutionised the treatment of coronary artery disease. There is a large spectrum of heterogeneity in what is classified as ‘multi-vessel disease’. A patient with discrete lesions of the right coronary and circumflex arteries who has a normal left ventricle or a patient with diffuse three-vessel disease and a poor ejection fraction can be rightly classified under the term ‘multi-vessel disease’. Optimal medical therapy (OMT) can be the initial strategy for majority of patients with mild symptoms and non-prognostic coronary disease.