Long-term survival of young patients with coronary artery disease is best realized through surgical revascularization with mammary arteries.

However, the annual event rate rose after the first 3 years, indicating that in patients with persistent or recurrent stable chest pain syndrome and initially negative stress testing, repeated DCMR diagnostic procedures might be warranted. Furthermore, early revascularization either by PCI or CABG both improved clinical outcome only in patients with inducible WMA by DCMR, whereas patients who underwent revascularization in the absence of inducible ischemia showed no significant benefit from invasive treatment. This is in agreement with recent randomized multicenter trials, where only patients with ischemia benefited from invasive procedures (11,12).