The usefulness of PCI to improve survival is uncer- tain in patients with 2- or 3-vessel CAD (with or without involvement of the proximal LAD artery) or 1-vessel proximal LAD disease.26,53,56,82 (Level of Evidence: B) 3. CABG might be considered with the primary or sole intent of improving survival in patients with SIHD with severe LV systolic dysfunction (EF <35%) whether or not viable myocardium is present.30,64 68,83,84 (Level of Evidence: B) 4. The usefulness of CABG or PCI to improve survival is uncertain in patients with previous CABG and extensive anterior wall ischemia on noninvasive test- ing.85 93 (Level of Evidence: B) Class III: HARM 1. CABG or PCI should not be performed with the primary or sole intent to improve survival in pa- tients with SIHD with 1 or more coronary stenoses that are not anatomically or functionally significant (eg, <70% diameter non left main coronary artery stenosis, FFR >0.80, no or only mild ischemia on noninvasive testing), involve only the left circumflex or right coronary artery, or subtend only a small area of viable myocardium.30,53,60,61,94 98 (Level of Evidence: B) 2.3. Revascularization to Improve Symptoms: Recommendations Class I 1. CABG or PCI to improve symptoms is beneficial in patients with 1 or more significant (>70% diameter) coronary artery stenoses amenable to revasculariza- tion and unacceptable angina despite GDMT.82,99 108 (Level of Evidence: A) Class IIa 1. CABG or PCI to improve symptoms is reasonable in patients with 1 or more significant (>70% diameter) coronary artery stenoses and unacceptable angina for whom GDMT cannot be implemented because of medication contraindications, adverse effects, or pa- tient preferences. (Level of Evidence: C) 2. 