Factors That Should Not Influence Treatment Decisions The 2 medical indications for revascularization are to prevent death and cardiovascular complications and to improve symptoms and quality of life. Nonetheless, the use of revas- cularization has risen dramatically in the past 3 decades. Much of this increase appears to be for indications for which benefits in survival or symptoms in comparison with nonin- vasive therapies are unlikely.422 National data suggest that about 12% of PCIs could be inappropriate because they lack evident potential to improve either survival or symptoms.423 Several reasons influence patients and physicians to prefer revascularization when the likelihood of benefit is less than the potential risk of the procedure. An ingrained preference for action (ie, revascularization) over perceived inaction (ie, medical therapy alone) likely often influences the decision making of both patients and physicians.252 Moreover, some healthcare professionals are unduly pessimistic about survival with conservative medical therapy and inaccurately optimis- tic about the survival benefits of revascularization proce- dures.424 As indicated earlier, patients often believe mistak- enly that PCI has the potential to prevent AMI and prolong survival.423,425 In addition, the attendant expense and risk of combined antiplatelet therapy for an uncertain period of time might not be fully considered. Physicians are professionally obligated to provide accurate estimates of the risks, benefits, and costs of various therapeutic options that are based on the best available scientific data. Other factors can induce phy- sicians to recommend revascularization. 