Strategies for management of stable coronary disease in type 2 diabetes mellitus

In recent decades, there have been significant advances in both surgical and minimally invasive approaches to revascularization in ischemic heart disease. This article discusses the evidence from key clinical trials comparing the various management strategies in stable coronary artery disease, and culminates in a discussion of the recently published Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease (FREEDOM) trial, which randomized patients with type 2 diabetes mellitus and multivessel coronary disease to coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with drug-eluting stents, and found, for the first time, a survival advantage with CABG relative to PCI.