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Selecting optimal therapy for patients with multivessel coronary artery disease is an ongoing clinical challenge. Investigators recently reported the 5-year outcomes of the Medicine, Angioplasty, or Surgery Study (MASS II), in which 611 patients in Brazil with symptomatic two- or three-vessel CAD (42% and 58%, respectively, of the cohort) were randomized to medical therapy, percutaneous coronary intervention (72% with bare metal stents, 28% with balloon angioplasty), or coronary artery bypass grafting. Patients with left main coronary artery stenosis ≥50% and those with LV ejection fraction <40% were excluded. Only 10% of screened patients were eligible for enrollment, and 29% of those eligible were enrolled.
Overall mortality was similar am…