What is the outcome of revascularization for patients with diabetes mellitus?
Some evidence indicates that the presence of diabetes mellitus adversely affects the outcomes of revascularization. A large meta-analysis that included the BARI trial but not BARI 2D failed to identify any significant difference in mortality rate after CABG versus PCI for patients with diabetes mellitus.1079 In a more recent, collaborative analysis that pooled patient-level data from 10 randomized trials (again, not including BARI 2D), Hlatky and colleagues found that of the 1233 patients with diabetes mellitus, 23% of those assigned to CABG died, compared with 29% of those assigned to PCI.1080 By contrast, of the 6561 patients without diabetes mellitus, 13% and 14% died, respectively (P50.014 for interaction). The interaction between diabetes mellitus and treatment remained highly significant after adjustment for multiple patient characteristics and after exclusion of patients enrolled in the BARI 2D trial.