Evid Based Med doi:10.1136/eb-2013-101259
  • Therapeutics
  • Randomised controlled trial

Coronary revascularisation in patients with diabetes: a chance to be better

  1. Giulio G Stefanini
  1. Department of Cardiology, Bern University Hospital, Bern, Switzerland
  1. Correspondence to : Professor Stephan Windecker
    Department of Cardiology, Bern University Hospital, Freiburgstrasse 4, Bern 3010, Switzerland; stephan.windecker{at}

Commentary on: Farkouh ME, Domanski M, Sleeper LA, et al. Strategies for multivessel revascularisation in patients with diabetes. N Engl J Med 2012;367:2375–84.


In 2009, a pooled analysis of individual patient data from randomised clinical trials comparing percutaneous coronary interventions (PCI) with coronary artery bypass grafting (CABG) showed a survival benefit in favour of CABG.1 Techniques of both PCI and CABG evolved during the last decade with the use of drug-eluting stents (DES) and novel antiplatelet agents.


In the FREEDOM trial, patients with diabetes and multivessel coronary artery disease (CAD) were randomised with concealed allocation to PCI with DES (94% sirolimus-eluting and paclitaxel-eluting stents) or CABG. Key exclusion criteria were left main stenosis, severe heart failure, acute myocardial infarction (MI), CK>2× normal, prior cardiac surgery or PCI, previous stroke, contraindication to CABG/DES and extracardiac illness with expected survival <5 years. The primary endpoint was a composite …

Free Sample

This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of EBM.
View free sample issue >>

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

Navigate This Article