What were the results of the CARDia trial?
The results of the CARDia trial, which compared CABG and PCI in a population consisting entirely of subjects with diabetes, suggested that PCI with DES and CABG achieved similar outcomes. Of the 1,800 subjects enrolled in the SYNTAX trial, which compared CABG and PCI with paclitaxel-eluting stents, 452 had medically treated diabetes. At 1-year follow-up, the two treatments exerted a similar effect on survival, MI, and the composite endpoint of death, MI, or stroke. Patients with diabetes randomly assigned to receive PCI had a higher rate of repeat revascularization (20.3% after PCI versus 6.4% after CABG; P 0.001), and those with highly complex lesions (ie, SYNTAX score 33) had a higher mortality rate with PCI (13.5% versus 4.1%; P 0.04).