Author + information
- Stephen J. Nicholls, MBBS, PhD* (, )
- Kathy Wolski, MPH and
- Steven E. Nissen, MD, PhD
- ↵*Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio 44195
We thank Dr. Kaneda and colleagues for their interest in our report (1). We agree that the potential early occurrence of acute ischemic events may influence the ability to characterize the relationship between disease burden and progression with clinical outcome. However, it is likely that this will underestimate the degree of the association demonstrated in our analysis. During the current analysis, 0.9% of patients died and 1.8% experienced a myocardial infarction. Patients were followed for a mean of 21 months. Although we agree with our colleagues that some later events may have been related to the follow-up angiogram, the relationship between burden and outcome clearly becomes apparent at a very early stage during the course of these studies. The ongoing separation of the event curves is most likely to reflect the sequelae of the natural history of disease progression.
- American College of Cardiology Foundation