Patient has multiple problems Coronary artery disease ,hypertension,Obesity,high Uric acid,a non ST elevation MI,Complete heart block with Temporary pace maker with old Stenting in carotids once patient has Triple vessel disease and unstable angina most suitable revascularization procedure would be a Coronary artery by pass surgery but risk and benefit must be disscussed with cardiologist and Cardiothoracic surgeon.If patient is unwilling for surgery and there is no angina with optimal medical therapy. As she may have limited activity.Although now adays in good hands and at good centre risks are very low.But she may need a permanent Pace maker implantation. Be positive every thing will be allright.