Patient: Description of the condition (onset time, main symptoms, hospital visited, etc.): CT-enhanced dual-source examination was done at Xinhua Hospital on August 30, site and method: coronary artery (plain scan + CTA) Radiological manifestations: coronary artery plain scan showed: RCA, LM, LAD and CX showed multiple small patchy calcifications, no significant abnormalities were seen in various valve areas of the heart. The coronary CTA showed that the distribution of coronary arteries was right coronary dominant, and the origin of left and right coronary arteries was normal. the RCA was coarse and clear, and mixed plaque and soft plaque were seen in the proximal and middle segments of the RCA causing severe lumen stenosis; calcified plaque was seen in the distal segment of the RCA causing slight lumen stenosis. the LM was coarse and clear, and mixed plaque was seen causing mild lumen stenosis. the LAD was coarse and clear, and mixed plaque and soft plaque were seen in the proximal and middle segments of the LAD causing mild to moderate lumen stenosis. CX was coarse, clear, and mixed plaque and soft plaque were seen in the proximal and middle segments of CX, resulting in mild to moderate luminal stenosis. Radiological diagnosis: calcification of coronary artery branches and mixed plaque with multiple luminal stenosis are obvious, DSA is recommended. I have diabetes mellitus complicated by coronary artery disease, and I usually take heart medication. Is it necessary to have a stent in this case? Is it possible to treat with medication? Because the patient also suffers from more serious diabetes and other diseases? Cardiovascular Center of Beijing Tongren Hospital: First of all, it is clear that the CTA indicates that there are lesions in the coronary arteries, and the lesions are more serious, combined with your history of diabetes, you must strengthen the medication, such as taking aspirin, statin lipid-regulating drugs on time to avoid acute cardiac events. Also if you have high blood, you should control it well and pay attention to blood sugar management. Secondly, it depends on whether you have angina symptoms, if you have more typical symptoms, and under reasonable drug treatment, still can not control the symptoms, please perform coronary angiography as soon as possible, to further clarify the coronary artery lesions more accurate situation, and make a decision on the feasible way of blood transport reconstruction treatment (interventional treatment or surgical treatment). If you do not have angina attacks under strict medication, you do not need to have an angiogram immediately, but you should continue the above medication and follow up regularly, and your doctor will decide whether to have an angiogram at a later date. Of course, it is not necessary to perform interventional or surgical treatment after the results of the imaging test are clear. It is important to assess the expected outcome of the procedure, the safety of the procedure and the risk of the patient to undergo this procedure. In short, the decision to perform the procedure should be based on whether the patient can benefit from the procedure with relatively low and well-controlled risks.