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The authors’ reply
1 Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
2 King's College Hospital, London, UK
3 Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
Correspondence to:
Correspondence to Dr R K Riezebos, Onze Lieve Vrouwe Gasthuis, Department of Cardiology, PO Box 95500, 1090 HM, Amsterdam, The Netherlands; R.K.Riezebos@xs4all.nl
| The first 150 words of the full text of this article appear below. |
Immediate percutaneous coronary intervention (PCI) is currently thought to be useful for ischaemia at early onset, thereby minimising detrimental consequences of vessel occlusion. By selecting only those patients with onset of chest pain within 6 h (median 3 h) we included a consecutive series of acutely unstable patients. By definition this restricted the inclusion rate.1
Moreover, the use of creatine kinase-MB as an end point is questioned by Kumar et al.2 However, meta-analysis showed that less periprocedural tissue necrosis is associated with an improved clinical course.3 This and other evidence led to the consensus that PCI-related ischaemic events have adverse effects on patient outcome.4 However, it must be kept in mind that our study was not powered to detect a difference in survival. For this, one would need a trial with at least 10 000 patients to demonstrate an effect on mortality.
In addition, Kumar et al point to
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This article has been cited by other articles:
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Riezebos, R K, Laarman, G J, Tijssen, J G P
(2009). The authors' reply. Heart
95: 1456-1456
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