Preoperative vs Postoperative Revascularization in Coronary Heart Disease Patients Undergoing Time-Sensitive Non-Cardiac Surgery (CHRONOS-PCI)

Inclusion Criteria: * Age ≥18 years * Diagnosis of coronary heart disease with non-emergent indication for PCI confirmed by coronary angiography： * Non-ST-elevation acute coronary syndrome (NSTE-ACS) at low or intermediate ischemic risk * Chronic coronary syndrome (CCS) with one of the following anatomical characteristics (see Appendix 1 for definition): 1. Moderate or severe stenosis of the left main coronary artery 2. Multivessel disease involving the ostium of the left anterior descending artery 3. Three-vessel disease with ≥70% stenosis in each major epicardial vessel * Indication for time-sensitive non-cardiac surgery * Planned non-cardiac surgery under general anesthesia in the following surgical departments: thoracic surgery, gastrointestinal surgery, colorectal surgery, hepatobiliary and pancreatic surgery, or gynecology * For patients with malignant tumors requiring time-sensitive surgery: written informed consent confirming understanding and acceptance that, if randomized to the "PCI-first" group, their tumor surgery will be delayed until 90±14 days after PCI, with acknowledgement of potential risks (e.g., tumor progression, change in resectability) * Ability to understand the study requirements and sign written informed consent in the language provided by the research team Exclusion Criteria: * Age \>80 years * Severe thrombocytopenia (platelet count \<50×10⁹/L) * Cardiogenic shock, severe heart failure (NYHA class IV, Killip class IV, or LVEF ≤35%), malignant arrhythmias (including cardiac arrest, asystole, ventricular fibrillation, or sustained ventricular tachycardia), or other life-threatening conditions requiring resuscitation * Moderate-to-severe valvular heart disease, high-grade atrioventricular block, or other severe cardiac/pulmonary dysfunction incompatible with the planned surgery * Planned surgery with extremely high bleeding risk (e.g., intracranial surgery, spinal surgery, retinal surgery) * Patients with malignant tumors undergoing non-palliative surgery who are in poor general condition, defined as meeting any of the following: 1. Karnofsky performance score \<60 2. Eastern Cooperative Oncology Group (ECOG) performance status \>2 * Disease stage beyond surgical indications or estimated life expectancy \<1 year * Patients requiring emergency or urgent surgery due to critical illness * Severe renal dysfunction: serum creatinine \>442 μmol/L, GFR ≤30 mL/min/1.73 m², or currently on renal replacement therapy * Severe hepatic dysfunction: Child-Pugh class C or higher * Severe uncontrolled systemic infection * Advanced dementia with significant decline in quality of life requiring full-time care and support * Systemic thromboembolic disease (e.g., pulmonary embolism) making surgery unsuitable * Women who are pregnant, breastfeeding, or planning pregnancy during the study period * Severe, uncontrolled comorbid conditions continuously impairing physiological or psychological function * Participation in another clinical study within 3 months prior to enrollment * Any condition judged by the investigator to interfere with participation or study conduct