Author + information
- Edward L. Hannan, PhD∗ (, )
- Ye Zhong, MD,
- Gary Walford, MD,
- David R. Holmes Jr., MD,
- Ferdinand J. Venditti, MD,
- Peter B. Berger, MD,
- Alice K. Jacobs, MD,
- Nicholas J. Stamato, MD,
- Jeptha P. Curtis, MD,
- Samin Sharma, MD and
- Spencer B. King III, MD
- ↵∗School of Public Health, State University of New York at Albany, One University Place, Rensselaer, New York 12144-3456
We thank Dr. Matsoukis and colleages for their letter expressing an interest in our recent study (1).
Regarding the type of drug-eluting stents (DES) (first vs. second generation), 72% of the stents used in the propensity-matched DES/coronary artery bypass graft (CABG) pairs were second-generation DES, with the others being first-generation DES. When the pairs were limited to second-generation DES compared with CABG surgery, there were still no significant differences for mortality or for mortality/myocardial infarction/stroke. Repeat revascularization rates were again lower for CABG surgery, and the adjusted hazard ratio (AHR) was very similar to the AHR for all pairs (0.60 vs. 0.54 for all pairs).
It is possible that our results could have been different if we had used cardiac mortality instead of all-cause mortality, but unfortunately we did not have access to that measure.
It is not true that CABG surgery was associated with a significantly lower rate when we looked at the composite endpoint of mortality/myocardial infarction/stroke. As the letter states, we found the AHR to be 0.96 (95% confidence interval: 0.86 to 1.06), which is not significant because the confidence interval includes the number 1.
Please note: Dr. Sharma has reported that he receives research grant support from Boston Scientific, Inc.; and serves on the Speakers' Bureau of Boston Scientific Inc., Abbott Vascular, Lilly, and The Medicines Company. Dr. King has reported that he receives royalties from Cordis; and serves as an Advisory Board member of Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- American College of Cardiology Foundation