Coronary artery bypass graft or percutaneous coronary interventions in patients with diabetes: another nail in the coffin or "too close to call?".

Percutaneous coronary intervention (PCI) was introduced by Gruentzig as an alternative to bypass surgery and was originally applied for symptomatic patients with singlevessel disease. As technology advanced, angioplasty became a therapy for the more usual forms of multivessel disease. Randomized trials have justified the use of angioplasty in selected patients with multivessel disease with one glaring exception—diabetics. In the six years since the National Heart, Lung and Blood Institute (NHLBI) issued its clinical alert regarding the Bypass Angioplasty Revascularization Investigation (BARI) data, which showed superior five-year survival for coronary artery bypass graft (CABG) compared to angioplasty (1), interventional cardiologists have been hoping for a “recount.” Was there something unique about the population?