In this trial of 2368 diabetics with CAD, they randomized (in a 2X2 factorial fashion) to either revascularization (within 4 weeks) or medical treatment, and to either insulin provision therapy (insulin or sulfonylurea) or insulin sensitization therapy (metformin or thiazolidinedione). There were no significant differences between the groups in 5-year death / major cardiovascular events. However, those undergoing CABG (and not PCI) had lower CV events than those undergoing medical treatment (abstract). An editorialist summarizes the findings:For diabetics with CAD, initial medical therapy is reasonable, but if revascularization is warranted, CABG is the preferred choice for diabetics.
Share This Post
Categories
Related Posts
While all of us see patients who smoke in their 70s or 80s, due to their limited lifespan from COPD, DM, malignancy, etc., and their expressed wishes to continue tobacco, we keep our admonitions to a minimum. We accept our patient has become learned enough through life to make their own decisions and accept whatever […]
Do you have a stack of journals piling up on your desk, beside your bed or in your email inbox? In 1950, medical knowledge was estimated to double every 50 years, but now the doubling time is every few months. At this rate, it is impossible to keep up with the literature, but a group […]
Fill in the Blanks: Q: “The diagnosis of type 2 MI is associated with a _____ prognosis. ___% of patients will live five years after their diagnosis.” The answer is a) POOR and b) a staggering 40%. I did not know that. However, what I am aware of is the ambiguity around Type 2 MIs and […]
Leave A Comment