Comparing Advanced Imaging-Guided Percutaneous Coronary Intervention and Coronary-Artery Bypass Grafting in Adults with Diabetes and Three-Vessel Coronary Artery Disease

What this Trial Is About

Researchers are comparing two treatment approaches for patients with diabetes and significant three-vessel coronary artery disease CAD that does not involve the left main artery. This randomized study aims to evaluate outcomes between imaging- and physiology-guided state-of-the-art percutaneous coronary intervention PCI and coronary artery bypass grafting CABG. The trial focuses on how these methods affect major cardiac and cerebrovascular events in this patient group. Participants will receive either PCI guided by advanced imaging and physiological assessments, including intravascular ultrasound IVUS or optical coherence tomography OCT, and tools like fractional flow reserve FFR or instantaneous wave-free ratio iFR, along with modern drug-eluting stents and optimal medical therapy, or they will undergo standard CABG surgery. Both treatments are delivered under careful clinical protocols, and patients will be followed up extensively to assess various health outcomes. During the study, participants will be monitored for major adverse events over two years and other cardiovascular outcomes over five years. Assessments include hospitalization duration, rehospitalization rates, changes in functional class, quality of life questionnaires, medication use, and healthcare costs. The study aims to provide comprehensive data on the effectiveness and safety of these two revascularization strategies, with participants involved in clinical follow-ups and evaluations throughout the study period.

Diabetes-Centered Evaluation of Revascularization Strategy of Functional and Imaging-CombiNEd State-of-the-Art Percutaneous Coronary Intervention or Coronary-Artery Bypass Grafting in Patients With Diabetes Mellitus and Multivessel Coronary Artery Disease