Therefore, the choice of revascularization in patients with CAD and LV systolic dysfunction is best based on clinical variables (eg, coronary anatomy, presence of diabetes melli- tus, presence of CKD), magnitude of LV systolic dysfunction, patient preferences, clinical judgment, and consultation be- tween the interventional cardiologist and the cardiac surgeon. 3.9.5. Previous CABG In patients with recurrent angina after CABG, repeat revas- cularization is most likely to improve survival in subjects at highest risk, such as those with obstruction of the proximal LAD artery and extensive anterior ischemia.373 381 Patients with ischemia in other locations and those with a patent LIMA to the LAD artery are unlikely to experience a survival benefit from repeat revascularization.380 Cohort studies comparing PCI and CABG among post- CABG patients report similar rates of mid- and long-term survival after the 2 procedures.373,376 379,381,493 In the patient with previous CABG who is referred for revascularization for medically refractory ischemia, factors that may support the choice of repeat CABG include vessels unsuitable for PCI, Figure 2. 1-year mortality after revascularization for multivessel disease and diabetes mellitus. An OR of 1 suggests an advantage of CABG over PCI. ARTS I indicates Arterial Revascularization Therapy Study I474; BARI I, Bypass Angioplasty Revascularization Investiga- tion I362; CARDia, Coronary Artery Revascularization in Diabetes475; CI, confidence interval; DM, diabetes mellitus; MASS II, Medicine, Angioplasty, or Surgery Study II366; OR, odds ratio; SYNTAX, Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery; and W, weighted.364 Hillis et al 2011 ACCF/AHA CABG Guideline e675 number of diseased bypass grafts, availability of the IMA for grafting, chronically occluded coronary arteries, and good distal targets for bypass graft placement. 