Diabetes mellitus and coronary revascularization procedures

Revascularization strategy for coronary artery disease in diabetic patients remains a field of controversy. Percutaneous coronary intervention has a less favourable outcome in these patients, though drug eluting stents have significantly improved the outcome. Although in most series, the outcome with coronary artery bypass grafting is worse in diabetic populations, surgery seems to be superior to angioplasty, particularly in diabetics with multivessel disease. Results from randomized trials such as the ongoing FREEDOM, CARDia and SYNTAX may define the role of each procedure in the treatment of diabetic patients with coronary artery disease.