The current treatment of myocardial ischemia in coronary artery disease is mainly pharmacological, interventional (PCI) and surgical bypass surgery (CABG). In addition to anti-myocardial ischemia, the treatment of coronary artery disease should also include controlling the risk factors of atherosclerosis, preventing and controlling the mechanical dysfunction of the heart and serious disturbance of cardiac electrical activity caused by ischemia, as well as maintaining a good rheological status of the whole body and the local coronary circulation. These three treatments for coronary heart disease are all aimed at the treatment of myocardial ischemia, while other aspects of treatment mainly rely on drug therapy. Even patients who choose interventional or surgical treatment need to receive drug therapy at the same time to control the risk factors of coronary heart disease, improve prognosis and treat residual ischemia after incomplete hemodynamic reconstruction. Drug therapy mainly includes anti-ischemic therapy, anti-thrombotic therapy, treatment to slow down the progression of coronary vascular lesions or reverse them, improve cardiac function and prevent other ischemia-related complications. 2.Interventional treatment: Percutaneous coronary intervention (PCI) refers to a group of percutaneous interventional techniques that are used to eliminate or reduce the stenosis or blockage of autologous coronary arteries or bridge vessels, reconstruct cardiac blood flow and improve myocardial blood supply with the support of imaging systems and the application of catheter interventional techniques with the help of relevant devices and materials, including PTCA, intracoronary stent implantation, coronary plaque spinning, plaque spinning grinding, Currently, PCI mainly involves PTCA and intracoronary stent implantation, and other interventional techniques are rarely applied. The application of coronary interventional techniques is called a revolution in modern medicine. Since its birth in the 1970s, interventional materials have been continuously improved, operation techniques have become increasingly mature, and antiplatelet and antithrombotic therapy have been improved, so that the indications for interventional treatment have been broadened, the risks and complications of the procedure have been gradually reduced, and the success rate and safety of the operation have been improved, and it has become the most important treatment for coronary artery disease because of its small trauma, precise and reliable efficacy. It has become one of the most important tools for the treatment of coronary heart disease because of its low invasion, precise and reliable efficacy. The birth of drug-coated stents and the application of statin lipid-regulating drugs have greatly reduced the incidence of in-stent restenosis, which was a great obstacle to the development of interventional technology, and have shown encouraging prospects for the treatment of coronary artery disease with blood flow reconstruction. CABG is one of the most important ways of revascularization, with reliable efficacy, and has the advantage of more complete revascularization in complex lesions such as severe multi-branch, multi-site and diffuse lesions and bifurcation of important vessels. However, CABG has the advantages of high trauma, relatively high single-visit medical costs, and high surgical risks in elderly, frail and high-risk patients with severely impaired important organ functions, so the indications should be strictly controlled in clinical application. II. Factors affecting the choice of treatment methods for coronary heart disease (a) Factors originating from patients themselves 1. Type of coronary heart disease and clinical characteristics: Patients with different types of coronary heart disease, different clinical status and risk levels have different strategies for choosing treatment methods. For most patients with stable angina, the first choice is pharmacotherapy. Reasonable and standardized pharmacotherapy can often effectively control symptoms and improve prognosis. For patients with ST elevation acute myocardial infarction, they cannot rely solely on pharmacological treatment and require urgent hemodynamic reconstruction and opening of infarct-related vessels. For high-risk ACS patients with unstable disease, early PCI treatment may benefit patients even more. 2. Coronary artery lesions and anatomical conditions: The severity, nature, extent and distribution of coronary artery lesions, as well as the characteristics of the coronary artery itself and its relationship with the aorta, will directly affect the choice of treatment modality. If the stenosis is less than 70% and there is no evidence of ischemia or stable disease, pharmacological treatment can be chosen and the disease can be observed. If the stenosis is greater than 70% and there is objective evidence of myocardial ischemia, hemodynamic reconstruction is often required. The choice between PCI and CABG depends on the lesion and the anatomical conditions of the coronary artery, but in the majority of lesions with severe calcification, extremely diffuse lesions, extremely tortuous vessels, special lesions or abnormal locations of coronary openings that are difficult to reach with interventional instruments, CABG has a higher safety and procedural success rate. In the case of diffuse lesions in the subepicardial and end vessels, even if the stenosis is severe, hemodynamic reconstruction cannot be achieved by PCI and CABG, and only pharmacological treatment can be received. 3, the patient’s systemic condition and concomitant diseases: advanced age, recent stroke and hemorrhagic disease, thrombolytic therapy should not be selected during AMI; contrast allergy cannot be done for interventional treatment; patients with severe heart failure, renal failure, liver damage and respiratory dysfunction have high risk of CABG surgery, and it is appropriate to select pharmacological treatment or PCI. (B) The patient’s and family’s will The patient’s and family’s perception, for degree of knowledge and awareness of the disease and various treatment methods, confidence and trust in the hospital and doctors to complete the relevant treatment, etc. influence their inclination and willingness to choose the treatment method, thus influencing or deciding the choice of the final treatment method. (III) Affordability of medical costs There are significant differences in the first medical costs of the three treatment methods. The high single treatment costs of interventional therapy and bypass surgery are difficult for many patients’ families to afford under the existing national conditions, and even though the condition is suitable and requires such treatment, the limitations of their economic conditions force them to give up the best choice of treatment method. In addition, some patients with poor economic status, in order to pursue the so-called “advanced treatment methods”, have to spend all their money on stenting or bypass surgery, thus affecting or failing to support the subsequent secondary prevention of coronary heart disease and “frame preservation”. “Bridge protection” treatment, not only difficult to benefit, and may even be harmful. (4) Accessibility of medical services Although the urban and rural medical and health conditions in China have been significantly improved since the reform and opening up, the geographical differences caused by unbalanced development are still obvious. The choice of treatment methods is inevitably limited. Therefore, medical professionals need to choose the best treatment plan with reasonable cost effectiveness ratio for patients according to their condition and local and neighboring medical resources. In conclusion, the choice of treatment for coronary artery disease requires a comprehensive risk/benefit and efficacy/cost assessment based on the type of coronary artery disease, risk level, anatomical features of the coronary lesion, systemic condition, personal wishes, and health care resources of the specific patient, with the goal of reducing mortality, improving clinical prognosis, relieving or alleviating symptoms, and improving quality of life, in order to maximize patient benefit.