The Role of Revascularization Versus Medical Therapy in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease
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•• BARI Investigators: The final 10-year follow-up results from the BARI randomized trial. The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. J Am Coll Cardiol 2007, 49:1600–1606. BARI was a major trial randomizing patients with multivessel CAD to revascularization with PCI or CABG. The trial showed a mortality benefit with CABG over PCI, which persisted at long-term follow-up of 10 years. The major limitation is that the trial was conducted before the modern era of PCI with DES.
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•• BARI 2D Study Group: A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med 2009, 360:2503–2515. This trial is the first in the modern era of revascularization with DES to randomize diabetic patients with CAD to medical therapy alone or to revascularization with PCI or CABG. The results reinforced those from COURAGE and expanded the findings to the higher-risk diabetic population by demonstrating equivalent mortality between optimal medical therapy alone and revascularization with PCI or CABG (in those without high-risk features such as left main disease).
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