Although 1 large analysis evaluating 17 RCTs of PCI versus medical therapy (including 5 trials of subjects with ACS) found a 20% reduction in death with PCI compared with medical ther- apy,1043 2 other large analyses did not.138,1042 An evaluation of 13 studies reporting the data from 5442 patients with non- acute CAD showed no advantage of PCI over medical therapy for the individual endpoints of all-cause death, cardiac death or MI, or nonfatal MI.1044 Evaluation of 61 trials of PCI conducted over several decades shows that despite improvements in PCI technology and pharmacother- apy, PCI has not been demonstrated to reduce the risk of death or MI in patients without recent ACS.138 The findings from individual studies and systematic re- views of PCI versus medical therapy can be summarized as follows: PCI reduces the incidence of angina.366,407,1016,1020,1033,1045 PCI has not been demonstrated to improve survival in PCI may increase the short-term risk of MI.366,397,1041,1045 PCI does not lower the long-term risk of 5.6. CABG Versus PCI The results of 26 RCTs comparing CABG and PCI have been published: Of these, 9 compared CABG with balloon angio- plasty,30,368,1017,1046 1059 14 compared CABG with BMS im- plantation,1022,1054,1060 1076 and 3 compared CABG with DES 5.6.1. CABG Versus Balloon Angioplasty or BMS A systematic review of the 22 RCTs comparing CABG with balloon angioplasty or BMS implantation concluded the 1. Survival was similar for CABG and PCI (with balloon angioplasty or BMS) at 1 year and 5 years. Survival was similar for CABG and PCI in subjects with 1-vessel CAD (including those with disease of the proximal portion of the LAD artery) or multivessel CAD. 2. Incidence of MI was similar at 5 years after randomization. 3. Procedural stroke occurred more commonly with CABG than with PCI (1.2% versus 0.6%). 4. 