title: Is there an additional benefit from coronary revascularization in diabetic patients with acute coronary syndromes or stable angina who are already on optimal medical treatment?
abstract: Cardiovascular disease (CVD) is common in patients with diabetes mellitus (DM) and related clinical outcomes are worse compared with non-diabetics. The optimal treatment in diabetic patients with coronary heart disease (CHD) is currently not established. We searched MEDLINE (1975-2010) using the key terms diabetes mellitus, coronary heart disease, revascularization, coronary artery bypass, angioplasty, coronary intervention and medical treatment. Most studies comparing different revascularization procedures in patients with CHD favoured coronary artery bypass graft (CABG) surgery in patients with DM. However, most of this evidence comes from subgroup analyses. Recent evidence suggests that advanced percutaneous coronary intervention (PCI) techniques along with best medical treatment may be non-inferior and more cost-effective compared with CABG. Treatment of vascular risk factors is a key option in terms of improving CVD outcomes in diabetic patients with CHD. The choice between medical therapy and revascularization warrants further assessment.
authors.affiliation: 2  Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.
authors.forename: Vasilios G
authors.initials: VG
authors.lastname: Athyros
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Gossios
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tziomalos
authors.forename: Matilda
authors.initials: M
authors.lastname: Florentin
authors.forename: Asterios
authors.initials: A
authors.lastname: Karagiannis
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis