The observational study by researchers at Cedars-Sinai Medical Center in Los Angeles found that people who had coronary artery bypass or angioplasty had a lower death rate (2 percent) than people who received drug therapy (6.7 percent) to improve blood flow to the heart.
But people with little or no blood flow restriction to the heart had better results on medication alone.
Their research appears in the May 26 issue of Circulation.
Narrowed arteries can reduce the flow of blood and oxygen to the heart during stress (ischemia). People with this kind of stable coronary artery disease have the choice of using medication or surgery or angioplasty to prevent a heart attack.
The researchers reviewed data on 10,627 people with reduced blood flow to the heart who received treatment. None of them had a history of heart attack. During follow-up, there were 146 cardiac-related deaths in the entire group.
Women -- particularly the elderly and those with diabetes -- had greater overall death rates as well as lives saved per 100 people treated with surgery or angioplasty.
More than 17 percent of diabetic women with large parts of their heart affected by ischemia were predicted to die if they took drugs compared to 4.4 percent if they had surgery or angioplasty, the study says.
Here's where you can learn more about ischemia.