A 68-year-old man with a 5-year history of stable angina presents for evaluation of chest pain that occurs with exertion and is relieved by rest. His symptoms are well-controlled on atenolol, lisinopril, atorvastatin, and sublingual nitroglycerin as needed. Coronary angiography reveals 75% stenosis of the left anterior descending artery and 80% stenosis of the left circumflex artery, with no significant left main coronary disease. His left ventricular ejection fraction is 50%. Stress testing demonstrates moderate, reversible ischemia in the distribution of both diseased vessels. Which of the following is the most appropriate next step in management?

1. A)Percutaneous coronary intervention of the left anterior descending artery only, deferring treatment of the left circumflex lesion
2. B)Coronary artery bypass grafting, as multivessel disease always requires surgical revascularization
3. C)Immediate revascularization of both vessels, as the degree of stenosis mandates intervention regardless of symptom severity
4. D)Percutaneous coronary intervention of both vessels as the preferred initial strategy due to lower procedural risk compared to bypass surgery
5. E)Continuation of optimal medical therapy with consideration of revascularization only if symptoms become refractory to medical managementGABARITO