|Problem||T2DM & IHD|
|Treatment||PCI or CABG|
|Inclusion criteria||Diagnosis of both type 2 diabetes and coronary artery disease.
The diagnosis of type 2 diabetes was based on the need for treatment with insulin or oral hypoglycemic drugs or a confirmed elevated blood glucose level.
The diagnosis of coronary artery disease was documented on angiography (>50% stenosis of a major epicardial coronary artery associated with a positive stress test or >70% stenosis of a major epicardial coronary artery and classic angina).
All patients had to be candidates for elective percutaneous coronary intervention (PCI) or coronary-artery bypass grafting (CABG).
|Exclusion criteria||Patients were excluded if they required immediate revascularization or had left main coronary disease, a creatinine level of more than 2.0 mg per deciliter (177 mmol per liter), a glycated hemoglobin level of more than 13.0%, class III or IV heart failure, or hepatic dysfunction or if they had undergone PCI or CABG within the previous 12 months.|
|Follow-up||3 - 6 years|
|Primary endpoint||Rate of death|
|Secondary endpoint(s)||Composite of death, myocardial infarction, or stroke (major cardiovascular events)|
|Brief summary:||PCI not superior to medical therapy. CABG reduced CV events.|
|PAPER: A randomized trial of therapies for type 2 diabetes and coronary artery disease.|
|Date||11 Jun 2009|
|Journal||N Engl J Med. 2009 Jun 11;360(24):2503-15.|
|Information||Revasc (CABG or PCI) vs. medical therapy for T2DM & IHD
-No difference in survival (p=0.97)
-No difference in CV events (death, MI or stroke) (p=0.70)
-PCI subgroup: no significant difference endpoints
-CABG subgroup: significant reduction in CV events (p=0.01)
N.B. Physician decided whether patients for CABG or PCI - Not randomised