Coronary Artery Bypass or Percutaneous Intervention in Chronic Coronary Syndrome: A Focused Review of the 2024 European Society of Cardiology Guidelines

In this review we summarise the 2024 ESC guideline recommendations comparing the role of PCI and CABG in chronic coronary syndromes (CCS), highlighting common clinical scenarios, evidence levels, and decision-making principles. The guidelines support CABG as the preferred strategy for left main and complex multivessel disease, particularly among patients with diabetes mellitus and/or left ventricular dysfunction. PCI provides comparable survival outcomes in low-anatomical-complexity disease (e.g