Treatment strategies in patients with diabetes and three-vessel coronary disease: What should we choose?

The recent study demonstrating that percutaneous coronary intervention and coronary artery bypass grafting were associated with a lower risk of death and major adverse cardiac and cerebrovascular events (composite of all-cause death, myocardial infarction, or stroke) than with medical therapy among patients with diabetes and triple-vessel disease was very interesting. However, the nature of single-center nonrandomized and nonblinded studies that are not placebo controlled limits the extrapolation and generalizability of the results. As a result, the existing body of evidence does not fully support the use of revascularization treatment strategies in patients with diabetes and triple-vessel disease. Importantly, the safety of revascularization treatment strategies in this particular population remains uncertain. Therefore, further studies are needed to assess the risks and benefits of comprehensive treatment in these patients.