Orthog- onal angiograms of the left coronary artery and a left anterior oblique angiogram of the right coronary artery are usually sufficient to identify the infarct artery.435 Although most patients undergoing revascularization will receive a stent as part of the procedure, there are conflicting data on the impact of stenting over balloon angioplasty. Some studies reveal lower mortality rates,436 438 whereas others reveal no bene- fit439 or higher mortality rates.440 There are no data comparing the choice of BMS versus DES in cardiogenic shock; how- ever, BMS are often used because compliance with long-term DAPT is often unclear in the emergency setting. In patients with multivessel disease, revascularization of the noninfarct artery may be necessary to maximize myocar- dial perfusion. Alternatively, in patients with multivessel disease and particularly left main disease, emergency CABG as a primary reperfusion strategy may be preferred.50,441 Refractory cardiogenic shock unresponsive to revasculariza- tion may necessitate institution of more intensive cardiac support with a ventricular assist device or other hemodynam- ic support devices to allow for myocardial recovery or subsequent cardiac transplantation in suitable patients. 5.2.4. Revascularization Before Noncardiac Surgery: Recommendations Class IIa 1. For patients who require PCI and are scheduled for elective noncardiac surgery in the subsequent 12 months, a strategy of balloon angioplasty, or BMS implantation followed by 4 to 6 weeks of DAPT, is reasonable.442 448 (Level of Evidence: B) 2. For patients with DES who must undergo urgent surgical procedures that mandate the discontinua- tion of DAPT, it is reasonable to continue aspirin if possible and restart the P2Y12 inhibitor as soon as possible in the immediate postoperative period.444 (Level of Evidence: C) Class III: HARM 1. Routine prophylactic coronary revascularization should not be performed in patients with stable CAD before noncardiac surgery.449,450 (Level of Evidence: B) 2. 