(CABG Level of Evidence: B350,1003,1004; PCI Level of Evidence: C1003) Class IIa 1. CABG to improve survival is reasonable in patients with significant (>70% diameter) stenoses in 2 major coronary arteries with severe or extensive myocardial ischemia (eg, high-risk criteria on stress testing, abnormal intracoronary hemodynamic eval- uation, or >20% perfusion defect by myocardial perfusion stress imaging) or target vessels supplying a large area of viable myocardium.327,990 992 (Level of Evidence: B) 2. CABG to improve survival is reasonable in patients with mild moderate LV systolic dysfunction (EF 35% to 50%) and significant (>70% diameter stenosis) multives- sel CAD or proximal LAD coronary artery stenosis, when viable myocardium is present in the region of intended revascularization.365,412,999 1002 (Level of Evidence: B) 3. CABG with a left internal mammary artery (LIMA) graft to improve survival is reasonable in patients with significant (>70% diameter) stenosis in the proximal LAD artery and evidence of extensive ischemia.412,987,993,994 (Level of Evidence: B) 4. It is reasonable to choose CABG over PCI to im- prove survival in patients with complex 3-vessel CAD (eg, SYNTAX score >22), with or without involvement of the proximal LAD artery who are good candidates for CABG.964,980,987 989 (Level of Evidence: B) 5. CABG is probably recommended in preference to PCI to improve survival in patients with multi- vessel CAD and diabetes mellitus, particularly if a LIMA graft can be anastomosed to the LAD artery.991,1005 1008,1008 1011 (Level of Evidence: B) Class IIb 1. The usefulness of CABG to improve survival is uncertain in patients with significant (70%) diame- ter stenoses in 2 major coronary arteries not involv- ing the proximal LAD artery and without extensive ischemia.987 (Level of Evidence: C) 2. 