Wang R, Serruys PW, Gao C, et al. - Similar treatment impacts of percutaneous coronary intervention (PCI) vs coronary artery bypass grafting (CABG) on all-cause death were seen at 10 years in patients with three-vessel disease (3VD) and/or left main coronary artery disease (LMCAD), regardless of the presence of diabetes. CABG may confer a survival benefit in cases with insulin-treated diabetes.

• Total 1800 patients with 3VD and/or LMCAD randomized to either PCI or CABG in the SYNTAX trial were analyzed for 10-year survival in the SYNTAXES study.

• PCI conferred a numerically higher mortality risk in diabetics (n = 452) vs CABG at 5 years [19.6% vs. 13.3%].

• The opposite was noted between 5 and 10 years (PCI vs CABG: 20.8% vs 24.4%).

• All-cause death at 10 years did not differ significantly between patients undergoing PCI or CABG, regardless of diabetic status, the absolute treatment difference was 1.9% in diabetics.

• Dedicated trials are required to explore the link between revascularization strategy and very long-term ischaemic and safety results for patients with diabetes.