Con- versely, the concurrent administration of GDMT may sub- stantially improve long-term outcomes in patients treated with CABG in comparison with those receiving medical therapy alone. In the BARI 2D (Bypass Angioplasty Revas- cularization Investigation 2 Diabetes) trial of patients with diabetes mellitus, no significant difference in risk of mortality in the cohort of patients randomized to GDMT plus CABG or GDMT alone was observed, although the study was not powered for this endpoint, excluded patients with significant left main CAD, and included only a small percentage of patients with proximal LAD artery disease or LVEF ,0.50 (408). The PCI and CABG guideline writing committees endorse the performance of the ISCHEMIA trial, which will provide contemporary data on the optimal management strat- egy (medical therapy or revascularization with CABG or PCI) of patients with SIHD, including multivessel CAD, and moderate to severe ischemia. 5.5. PCI Versus Medical Therapy Although contemporary interventional treatments have low- ered the risk of restenosis compared with earlier techniques, meta-analyses have not shown that the introduction of bare metal stents (BMS) confers a survival advantage over balloon Fihn et al Stable Ischemic Heart Disease: Full Text e417 angioplasty1037 1039 or that the use of DES confers a survival advantage over BMS.138,1040 No study to date has demonstrated that PCI in patients with SIHD improves survival rates.138,366,408,959,985,987,1041 1044 Nei- ther COURAGE366 nor BARI 2D,408 which treated all pa- tients with contemporary optimal medical therapy, demon- strated any survival advantage with PCI, although these trials were not specifically powered for this endpoint. 