Coronary revascularization for patients with diabetes: updated data favor coronary artery bypass grafting.

Diabetes mellitus, by virtue of myriad processes, including its effects reducing vascular nitric oxide and prostacyclin production and increasing endothelin, angiotensin II, tissue factor activity, and platelet activity (1,2), wreaks havoc on coronary and other arteries, leading to diffuse and often unstable coronary atherosclerosis. It is also a risk factor for poor outcomes after both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) (3). Numerous randomized controlled trials have compared outcomes after PCI and CABG in patients with diabetes.