Problem T2DM & IHD
Format Multi-center RCT
Treatment PCI or CABG
Control Medical therapy
Population 2368 patients
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)
Details .
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