Author + information
- Whady Hueb, MD* ()
- Paulo R. Soares, MD and
- Eulógio Martinez, MD
We thank Dr. Rott for his comments regarding our article (1). In the MASS-II study, 59% of patients treated with coronary artery bypass graft surgery (CABG) and 52% treated percutaneously were free of angina at one year, figures significantly better than the 36% of patients without symptoms in the medically treated group (with no difference between surgery and stenting). As pointed out by Dr. Rott, a placebo effect related to the invasive nature of the former modalities cannot be ruled out as a possible component to justify the symptomatic improvement among these patients. However, we should emphasize that the difference in the symptomatic status of the study groups was paralleled by a highly significant reduction in the rate of objective ischemia among the groups, which was greater for the surgical and percutaneous groups (36% and 18%, respectively) than for medically treated patients (5%). Therefore, we trust that most (if not all) of the symptom relief observed among patients treated with myocardial revascularization might have been related to actual ischemia reduction.
- American College of Cardiology Foundation