Clinical Research Directory

Inclusion Criteria: 1. Age ≥ 21 years with angina and/or evidence of myocardial ischemia 2. Three vessel CAD, defined as ≥ 50% diameter stenosis by visual estimation in each of the three major epicardial vessels or major side branches, but not involving left main coronary artery, and amenable to revascularization by both PCI and CABG as determined by the Heart Team. Patients with a non-dominant right coronary artery may be included if only the left anterior descending artery (LAD) and left circumflex have ≥50% stenosis 3. Willing and able to provide informed, written consent Exclusion Criteria: 1. Requirement for other cardiac or non-cardiac surgical procedure (e.g., valve replacement, carotid revascularization), however a maze procedure or pulmonary vein isolation is allowed 2. Cardiogenic shock and/or need for mechanical/pharmacologic hemodynamic support 3. Recent STEMI (\<5 days prior to randomization) 4. Ongoing Non STEMI with biomarkers (cardiac troponin) still rising 5. Known left ventricular ejection fraction \<30% 6. Life expectancy \< 2 years 7. Requiring renal replacement therapy 8. Undergoing evaluation for organ transplantation 9. Participation or planned participation in another clinical trial, except for observational registries 10. Pregnancy 11. Inability to take dual antiplatelet therapy or anticoagulation and single antiplatelet therapy for at least six months 12. Previous CABG 13. Left main disease requiring revascularization 14. Extremely calcified or tortuous vessels precluding FFR measurement 15. Any target lesion with in-stent drug-eluting stent restenosis 16. More than one major epicardial vessel which is chronically occluded