Background: To assess long-term survival in unselected patients with coronary artery disease in who an invasive approach is considered. Methods: All patients with significant coronary artery disease who were presented for coronary revascularisation to two tertiary centres in 1992 were included. Follow-up data were collected in September 2002. Multivariate Cox’proportional-hazards regression analysis was applied to assess the independent relation between variables and 10 -year survival. Results: A total of 877 patients were included in this analysis . Mean age was 62 and the most common clinical diagnosis was chronic stable angi na(60%). Diabetes was present in 12%of the patients. During the follow-up per iod, 233 patients(27%)died. Predictors of long-term survival were increasing a ge, diabetes, peripheral vascular disease and a decreased left ventricular funct ion. Compared to medical treated patients, those treated with revascularisation( either by PCI or CABG) had a decreased long-term mortality(p< 0.05). Of the pat ients with PCI 27%had died, compared to 24%in those who had CABG and 36%of th ose who were treated medically. However, after adjusting for differences in base line variables, conservative treatment was no significant predictor of long-ter m mortality. After multivariable analyses, increasing age, decreased left ventri cular function and diabetes were independent predictors of long-term mortality. Conclusions: In patients with coronary artery disease in whom an invasive appro ach is considered, increasing age, impaired left ventricular function and diabet es are the strongest predictors of long-term mortality. After adjustments for d ifferences in baseline variables, invasive treatment is not associated with a lo wer long-term mortality. Background: To assess long-term survival in unselected patients with coronary artery disease in who an invasive approach is considered. Methods: All patients with significant coronary artery disease who were presented for coronary revascularisation to two tertiary centers in 1992 were included. Follow-up data were collected in September 2002. Multivariate Cox’proportional-hazards regression analysis was applied to assess the independent relation between variables and 10 -year survival. Results: A total of 877 patients were included in this analysis. Mean age was 62 and the most During the follow-up of per iod, 233 patients (27%) died. Predictors of long-term survival were increasing a ge, diabetes, peripheral vascular disease and a decreased left ventricular funct ion. compared to medical treated patients, those treated with revascularisation (either by PCI or CABG) had a decreased long-t Of the patients with PCI 27% had died, compared to 24% in those who had CABG and 36% of those who were treated medically. However, after adjusting for differences in base line variables, conservative treatment was no significant predictor of long-ter m mortality. After multivariable analyzes, increasing age, decreased left ventri cular function and diabetes were independent predictors of long-term mortality. Conclusions: In patients with coronary artery disease in whom an invasive appro ach is considered, increasing age, impaired left ventricular function and diabet es are the strongest predictors of long-term mortality. After adjustments for d ifferences in baseline variables, invasive treatment is not associated with a lo wer long-term mortality.