Diabetic patients require global care

The results of the BARI 2D trial demonstrate that diabetic patients with stable CAD need more than just stents or grafts, namely a global care including, in addition to coronary revascularization, aggressive cardiovascular risk factor management and life style changes. In the presence of an excellent compliance, a strategy based on initial medical management followed by coronary revascularization if clinically indicated is a good option for diabetic patients with stable CAD.

A total of 2368 diabetic patients with stable CAD and qualifying for coronary revascularization were randomized to optimal medical therapy or revascularisation − either with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) − in addition to optimal medical therapy. Primary end points of the study were the 5-.year rate of death and major cardiovascular invents (MACE) defined as a composite of death, myocardial infarction or stroke. Survival and MACE-free survival at follow-up did not differ between the revascularisation group and the medical therapy group. At 5 years, 42% of the patients randomised to medical management did require coronary revascularisation. Both groups were characterized by an excellent compliance with respect to medical therapy.

*Published on June 11th 2009 in the New England Journal of Medicine.

Source: European Society of Cardiology (news : web)