Currently, cardiovascular disease has become the number one killer threatening human health. Especially with the continuous improvement of people’s living standard, the incidence of coronary heart disease is also increasing year by year. At present, there are three main ways to treat coronary heart disease, drug treatment, stent intervention and coronary artery bypass surgery treatment. So as a patient and his family, they may be more concerned about what kind of treatment should I choose? I would like to compare stent intervention and coronary artery bypass surgery with drug treatment, which has limited effect. In the 1970s, people began to try to dilate narrowed coronary arteries with balloons, but simple dilation was prone to postoperative restenosis, and it was thought that implanting a metal stent into the dilated site could well prevent the collapse of the vessel. Needless to say, stent intervention is favored by the majority of patients because of its low invasiveness and quick recovery, so this procedure has flourished. But new problems have arisen, as diseased vessels can quickly grow too many cells to encircle the eroding metal stent, especially at the ends of the stent, where restenosis is more likely to occur. In recent years, clever researchers have invented drug extended-release stents, which are bare metal stents with a “coat” of chemotherapy drugs that are slowly released to reduce restenosis, called drug extended-release stents (DES). When the U.S. Food and Drug Administration (FDA) approved DES for clinical coronary artery therapy in 2003, it appeared that the battle for coronary artery disease had been won, and some even began to celebrate this victory. However, the reality is that drug-release stents only reduce the incidence of in-stent restenosis in the early postoperative period compared with bare metal stents, and their long-term efficacy has not been determined, and the incidence of long-term thrombosis is higher than that of bare metal stents. Therefore, drug-release stents cannot completely replace bare metal stents, let alone replace the role and status of drug therapy and coronary artery bypass grafting (also known as coronary artery bypass grafting, CABG) in the treatment of coronary heart disease. Since the 1960s, coronary artery bypass grafting has become an effective measure in the treatment of coronary artery disease. It has been confirmed by a large number of comparative clinical trials that surgical coronary artery bypass grafting is still the best option for complex lesions (multiple diffuse lesions, especially combined with diabetes mellitus, three-branch lesions, left main stem lesions, cardiac insufficiency, etc.). Studies have shown that a 5-year patency rate of 96% for a bridge from the internal mammary artery to the anterior descending branch is still as high as 93% at 10 years, which is higher than the one-year patency rate of several current clinical studies on drug-relieved stents. However, people are often prone to fear the major trauma and bleeding of surgical procedures, and have doubts about slow postoperative recovery or possible complications, so they have concerns about the proven, long-term effectiveness of coronary bypass surgery. In fact, the increasing advances in modern surgical techniques and anesthesia technology have made surgical procedures safer and more effective. Minimally invasive coronary bypass surgery (OPCAB), for example, is a surgical operation performed on a beating heart, avoiding the complications caused by extracorporeal circulation. There is also the advent of robot-assisted coronary artery bypass grafting, which has minimized surgical trauma. The overall mortality rate of coronary bypass surgery in our hospital is now less than 1% and the long-term results are excellent. The latest SYNTAX study is the first international, multi-center clinical study comparing hemodynamic reconstruction strategies for left main and/or multi-branch vascular lesions. The study was conducted at 84 study centers in Europe and the United States, and patients who could be treated with either coronary artery bypass grafting or stent intervention were randomized to either bypass grafting (897 patients) or placement of a drug stent (903 patients). The primary endpoint of the study was the risk of major adverse cardiovascular and cerebrovascular events, including death, stroke, and repeat revascularization. The risk of major adverse cardiovascular events was significantly higher in the stent intervention group than in the coronary artery bypass group (17.8% vs. 12.1%). the most outstanding contribution of the SYNTAX study was the summary of the SYNTAX score. Those with lower SYNTAX scores (<22) had a slightly lower incidence of major adverse cardiovascular events after stenting than those in the coronary artery bypass group (13.5% vs. 14.4%), but the overall comparison was not statistically different. overall comparison was not statistically different. For patients with intermediate scores (22-32), there was no significant difference in the effect of stenting versus coronary artery bypass grafting on postoperative major adverse cardiovascular and cerebrovascular events, suggesting that the efficacy and safety of the two treatments were comparable, and in patients with higher SYNTAX scores (>33), there was a significant increase in postoperative major adverse cardiovascular and cerebrovascular events in the stenting group. Although the SYNTAX study was only followed up for one year, long-term follow-up is needed to determine its long-term efficacy. However, at this time, more scholars and clinicians believe that stent intervention may be superior in patients with lower SYNTAX scores. For patients with higher SYNTAX scores, coronary artery bypass grafting should be the treatment of choice. It should be noted that for patients with intermediate SYNTAX scores, the treatment modality should depend on the clinical characteristics of the patient, taking into account the concomitant disease, cardiopulmonary condition, etc. In conclusion, we should objectively evaluate the efficacy of both approaches in the context of the patient’s overall condition, so as to ensure the maximum benefit to the patient.