We’ve created tables of pros & cons (benefits and risks) for each of the treatment options presented in the Research section of this website. These include coronary artery bypass graft (CABG) surgery, percutaneous coronary intervention (PCI, also called angioplasty), and medications (drugs) only.

The information in these tables is from research. Research can’t predict exactly what will happen in your case. Your doctor and heart team can better predict what might happen to you. They will tell you about what treatment is best for your situation. Their recommendation will depend on how quickly you need treatment to restore blood flow to your heart, how bad your heart disease is, and other conditions that you have.

See the tables below for general pros & cons for all patients with coronary artery disease, as well as information specific to those patients who also have diabetes.

Treatment Pros & Cons

General Information for All Patients with Coronary Artery Disease

IMPORTANT: No matter what treatment choice you make, you will always be given a prescription for medications. Take a look at each of the tables below to compare treatment options.

CABG + Medications PCI + Medications Medications Only
What are some potential benefits/pros?
  • Compared to no treatment:
    • Live longer
    • Reduce chest pain
  • Can treat multiple narrowed arteries at once
  • Compared to no treatment:
    • Live longer
    • Reduce chest pain
  • Can treat multiple narrowed arteries at once
  • Can sometimes be done at the same appointment/same time as angiography
  • No major surgery or overnight hospital stay
  • Can usually return to work and normal routine within 1 week of treatment
  • Compared to no treatment:
    • Live longer
    • Reduce chest pain
  • Helps manage cholesterol, blood clots, and blood pressure
  • No in-hospital treatment/procedure
  • Can usually return to work and normal routine right away
  • Can fill prescription and begin treatment right away (no wait time)
  • Can be as effective as PCI + medications in stable CAD1
What are some potential risks/cons?
  • Wait time: could have to wait weeks to months for treatment
  • Involves general anesthesia (you will be unconscious and feel no pain)
  • Recovery time (about 6 – 12 weeks)
  • Involves hospital stay (about 1 week)
  • Personal costs: home care, medications, travel time, time away from work
  • Health risks:
    • Stroke
    • Infection
    • Kidney problems
    • Heart attack
    • Short-term memory problems
    • Re-narrowing of arteries (may need another surgery or PCI)
    • Death
    • Side effects specific to medication type
  • Wait time: could have to wait days to weeks for treatment
  • Involves sedation (you will be conscious but feel no pain)
  • Recovery time (about 1 day)
  • Involves hospital stay (about 1 day)
  • Personal costs: medications, travel time, time away from work
  • Health risks:
    • Blood clots
    • Re-narrowing of arteries (may need multiple treatments)
    • Kidney problems
    • Heart attack
    • Coronary artery damage
    • Side effects specific to medication type
  • Personal costs: medications, travel time, time away from work
  • Health risks:
    • Symptoms and disease may worsen and you may need PCI or surgery later on
    • Heart attack
    • Stroke
    • Bleeding
    • Side effects specific to medication type

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Treatment Pros & Cons

Information for Patients with Diabetes and Coronary Artery Disease

1. See Potential Benefits (Pros)

Potential Benefits/Pros CABG + Medications PCI + Medications Medications Only
Living longer

a) Three years after treatment for coronary artery disease when many blood vessels supplying the heart are blocked/narrowed, more patients are alive after CABG compared to PCI1

b) Five years after treatment there are no differences in survival between treatments for coronary artery disease when only 1–2 blood vessels supplying the heart are narrowed/blocked2

 a) 90% of patients are alive

b) 88% of patients are alive

 a) 85% of patients are alive

b) 89% of patients are alive

 a) n/a

b) 88% of patients are alive
Less angina (chest pain)

Five years after treatment for coronary artery disease when many blood vessels supplying the heart are blocked/narrowed, more patients are angina free after CABG compared to PCI3

 79% of patients have no angina 74% of patients have no angina n/a
Chance of having a heart attack

Five years after treatment for coronary artery disease when many blood vessels supplying the heart are blocked/narrowed, less patients have a heart attack after CABG compared to PCI or medication only2

 7% of patients had a heart attack 14% of patients had a heart attack 15% of patients had a heart attack
Chance of needing additional PCI or CABG treatment

Three years after treatment for coronary artery disease when many blood vessels supplying the heart are blocked/narrowed, less people needed additional treatment after CABG compared to PCI4

 5% of patients needed additional treatment (PCI or CABG) 13% of patients needed additional treatment (PCI or CABG) n/a
Quality of life2 Patients report greater improvements in their mental and physical abilities 5 years after CABG compared to PCI Patients report greater improvements in their mental and physical abilities in the first month after PCI compared to CABG n/a

2. See Potential Risks (Cons)

POTENTIAL RISKS/CONS CABG + Medications PCI + Medications Medications Only
Chance of having a stroke
Five years after treatment for coronary artery disease when many blood vessels supplying the heart are blocked/narrowed, more people had a stroke after CABG compared to PCI or medication only2		 4% of patients had a stroke 3% of patients had a stroke 3% of patients had a stroke
Other health risks You should talk to your doctor about your chances of having these problems during or soon after CABG:

  • Infection.
  • Pain
  • Kidney problems.
  • Heart rhythm difficulties (atrial fibrillation)
  • Short-term problems with thinking, memory, depression, and anxiety
 You should talk to your doctor about your chances of having these problems during or soon after PCI:

  • Bleeding
  • Damage to blood vessels
  • Pain
  • Bruising
  • Tenderness
  • Need for emergency CABG
 You should talk with your doctor about potential risks and side effects of your medications
Wait times
You will have to wait to receive CABG and this may involve travelling to/from the hospital for appointments		 Unless you need treatment right away to save your life, you will need to wait to have your surgery Many patients can have PCI immediately after their angiography investigation No waiting is necessary
Personal costs
All treatment requires that you pay for your medication(s), unless you have coverage through a health benefits plan. Depending on where you live, you may need to pay in time and money to travel to/from your appointments		 CABG itself will not cost you anything other than time away from home and time off work. It will cost money to fill your medication prescriptions at a pharmacy PCI itself will not cost you anything other than time away from home and time off work (though less than with CABG). It will cost money to fill your medication prescriptions at a pharmacy It will cost money to fill your medication prescriptions at a pharmacy
Recovery
Recovery from CABG is much longer than after PCI treatment		 You are likely to spend 5-10 days in hospital. You will not be able to drive for 4 weeks. It can take 6-12 weeks for you to be able to return to your normal activities including work, sex and household duties Most people are able to return to their usual activities about 5 days after PCI No recovery time needed, though it make take time to get used to how your new medication(s) make you feel

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