The presence of angina does not confer a markedly poorer prognosis in medically treated patient. By intention-to-treat, mortality rates are similar in patients assigned to CABG or to medical therapy, whether angina is present or not. Patients treated with CABG had greater improvement in CCS angina class compared to patients treated with medical therapy only, but the treatment effect diminishes over time. Angina, unless recalcitrant to medical therapy, does not appear useful in selecting patients with CAD, heart failure and LV systolic dysfunction for CABG. CABG = coronary artery bypass graft; CAD = coronary artery disease; CCS = Canadian Cardiology Society; LV = left ventricular.