 The ischemia trial has provided evidence that revascularization may be beneficial for some patients with stable coronary artery disease, SCAD, but it remains unclear whether this benefit extends to all patients with SCAD. The ACC slash AHA 2021 revascularization guideline recommends revascularization for patients with three-vessel disease or proximal left anterior descending artery disease who have a positive stress test result. However, the guideline does not recommend revascularization for patients with single-vessel disease or non-proximal left anterior descending artery disease who have a negative stress test result. Additionally, the guideline states that revascularization should only be considered if the patient's symptoms are refractory to medical therapy. This article was authored by Leonid Burstein, Alexei Sumin, Elisaveta Zbyshevskia, and others.