Chronic coronary disease and diabetes: an invasive approach? Outcomes of Participants with Diabetes in the ISCHEMIA Trials
Among patients with diabetes mellitus (diabetes) and chronic coronary disease (CCD), it is unclear if invasive management improves outcomes when added to medical therapy. The ISCHEMIA Trials (ISCHEMIA and ISCHEMIA CKD) randomized CCD patients to an invasive (medical therapy + angiography and revascularization if feasible) or a conservative approach (medical therapy alone with revascularization if medical therapy failed). JD Newman et al. (NYU Grossman School of Medicine, New York, USA) aimed to determine if invasive management improves outcomes among patients with diabetes and chronic coronary disease, when added to medical therapy.
Take-home message: The authors combined the cohorts from the ISCHEMIA and ISCHEMIA CKD trials. Among the 5,900 participants, at a median follow-up of 3.1-years, there was no difference in death or MI between strategies for patients with vs. without diabetes, or for clinical (female sex or insulin use) or anatomic features (CAD severity or left ventricular function) of patients with diabetes