**4.7 Conclusions**

In this group of patients at high risk of diffuse coronary disease, there is evidence that patients with high scores are no doubt that surgery is the first option, although the only definitive evidence is FREEDOM despite its criticisms. Since the other studies could not be completed or did not show long-term follow-up, in patients with low scores, we believe that second-generation stents and perhaps new ultra-thin DES stents could shorten the gap between surgery events and angioplasty.
