Indications for performing CABG over PCI for a STEMI include which of the following?

Choosing coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is often indicated in specific clinical scenarios. One of these is the presence of left main coronary artery disease. The left main coronary artery supplies a significant portion of the heart, and blockage in this artery can lead to extensive ischemia and a high risk of mortality. CABG is generally preferred in this situation because it provides a more comprehensive revascularization of the heart compared to PCI, addressing the critical nature of left main stenosis and potentially improving outcomes. CABG allows multiple arteries to be bypassed in one procedure, which can be vital for patients with significant left main disease.

In comparison, single-vessel disease or situations with a normal left ventricle ejection fraction may typically be managed with PCI, as these conditions often allow for less invasive treatment options that still yield good results. Similarly, less than three-vessel disease does not meet the criteria for CABG over PCI in most standard guidelines unless there are other complicating factors. Thus, in the context of STEMI and the specific risks associated with left main coronary artery obstruction, CABG is the established approach to enhance survival and recovery chances.