Response to Letter Regarding Article, “Short- and Long-Term Outcomes With Drug-Eluting and Bare-Metal Coronary Stents: A Mixed-Treatment Comparison Analysis of 117 762 Patient-years of Follow-up From Randomized Trials”
2013; Lippincott Williams & Wilkins; Volume: 127; Issue: 6 Linguagem: Inglês
10.1161/circulationaha.112.145169
ISSN1524-4539
AutoresSripal Bangalore, Maria Fusaro, Nicholas Amoroso, Michael Attubato, Frederick Feit, James Slater, Sunil Kumar, Deepak L. Bhatt,
Tópico(s)Antiplatelet Therapy and Cardiovascular Diseases
ResumoHomeCirculationVol. 127, No. 6Response to Letter Regarding Article, "Short- and Long-Term Outcomes With Drug-Eluting and Bare-Metal Coronary Stents: A Mixed-Treatment Comparison Analysis of 117 762 Patient-years of Follow-up From Randomized Trials" Free AccessResearch ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessResearch ArticlePDF/EPUBResponse to Letter Regarding Article, "Short- and Long-Term Outcomes With Drug-Eluting and Bare-Metal Coronary Stents: A Mixed-Treatment Comparison Analysis of 117 762 Patient-years of Follow-up From Randomized Trials" Sripal Bangalore, MD, MHA, Mario Fusaro, MD, Nicholas Amoroso, MD, Michael J. Attubato, MD, Frederick Feit, MD and James Slater, MD Sunil Kumar, MD Deepak L. Bhatt, MD, MPH Sripal BangaloreSripal Bangalore New York University School of Medicine, New York, NY , Mario FusaroMario Fusaro New York University School of Medicine, New York, NY , Nicholas AmorosoNicholas Amoroso New York University School of Medicine, New York, NY , Michael J. AttubatoMichael J. Attubato New York University School of Medicine, New York, NY , Frederick FeitFrederick Feit New York University School of Medicine, New York, NY and James SlaterJames Slater New York University School of Medicine, New York, NY Sunil KumarSunil Kumar University of Nebraska, Omaha, NE Deepak L. BhattDeepak L. Bhatt VA Boston Healthcare System, Brigham and Women's Hospital and Harvard Medical School, Boston, MA Originally published12 Feb 2013https://doi.org/10.1161/CIRCULATIONAHA.112.145169Circulation. 2013;127:e447IntroductionSharma and Chatterjee compare and contrast our publication1 with a recent publication on stent thrombosis2 and are concerned with "divergent" results of the 2 studies. A thorough reading of both the articles shows that the results of the 2 articles are concordant, demonstrating that everolimus-eluting stents reduce the risk of stent thrombosis compared with other drug-eluting stents and even bare-metal stents. The differences are due largely to the design of the 2 studies. First, the focus of the Palmerini et al2 article was on stent thrombosis, whereas our focus was on not only stent thrombosis, but also other efficacy and safety outcomes, as outlined below. Second, Palmerini et al excluded studies that did not report stent thrombosis, whereas our study evaluated efficacy (target vessel revascularization/target lesion revascularization) and safety outcomes (death, myocardial infarction, or stent thrombosis). We therefore included trials that reported either of the 2 sets of outcomes, resulting in a larger number of trials. Third, Palmerini et al limited their search to trials reporting Academic Research Consortium–defined definite or probable stent thrombosis, whereas there was no such restriction in our search. However, we reported both trial-defined stent thrombosis and the Academic Research Consortium–defined stent thrombosis. The authors' contention about "possibly duplicate data from different publications on the same trial" is incorrect because all of the trials are clearly reported in the tables, and there are no duplicate data. In addition, all events were counted only once on the basis of trial-reported 1-year and longer-term events. The authors are once again incorrect in that our analyses used number of events, not logarithm of events. Finally, the authors state that the analysis by Palmerini et al found that everolimus-eluting stents were associated with lower definite stent thrombosis rate at "all durations of follow-up," even when compared with sirolimus-eluting stents and the Resolute zotarolimus-eluting stent. This is once more incorrect; the reported 2-year definite stent thrombosis comparison in the Palmerini et al article for everolimus-eluting stents versus sirolimus-eluting stents (odds ratio, 0.49; 95% confidence interval, 0.23–1.03) and for the everolimus-eluting stents versus the Resolute zotarolimus-eluting stent (odds ratio, 0.35; 95% confidence interval, 0.10–1.07) failed to reach statistical significance and is concordant with our analysis. Regardless of these analyses, our analysis is based on the totality of data including the probability analysis, in which everolimus-eluting stents had a >80% probability of having the lowest stent thrombosis rate compared with bare-metal stents or any of the drug-eluting stents, including sirolimus-eluting stents and the Resolute zotarolimus-eluting stents. In conclusion, the 2 articles corroborate each other's findings.Sripal Bangalore, MD, MHAMario Fusaro, MDNicholas Amoroso, MDMichael J. Attubato, MDFrederick Feit, MDJames Slater, MDNew York University School of MedicineNew York, NYSunil Kumar, MDUniversity of NebraskaOmaha, NEDeepak L. Bhatt, MD, MPHVA Boston Healthcare SystemBrigham and Women's Hospital and Harvard Medical SchoolBoston, MADisclosuresDr Bhatt is on the advisory board of Medscape Cardiology; on the board of directors of Boston VA Research Institute and Society of Chest Pain Centers; and chair of the American Heart Association Get With The Guidelines Science Subcommittee. Dr Bhatt has received honoraria from the American College of Cardiology (editor, Clinical Trials, Cardiosource), Duke Clinical Research Institute (clinical trial steering committees), Slack Publications (chief medical editor, Cardiology Today Intervention), and WebMD (CME steering committees), as well as research grants from Amarin, AstraZeneca, Bristol-Myers Squibb, Eisai, Ethicon, Medtronic, Sanofi Aventis, and The Medicines Company. Dr Bhatt has performed unfunded research for FlowCo, PLx Pharma, and Takeda. The other authors report no conflicts.References1. Bangalore S, Kumar S, Fusaro M, Amoroso N, Attubato MJ, Feit F, Bhatt DL, Slater J. Short- and long-term outcomes with drug-eluting and bare-metal coronary stents: a mixed-treatment comparison analysis of 117 762 patient-years of follow-up from randomized trials.Circulation. 2012; 125:2873–2891.LinkGoogle Scholar2. Palmerini T, Biondi-Zoccai G, Della Riva D, Stettler C, Sangiorgi D, D'Ascenzo F, Kimura T, Briguori C, Sabatè M, Kim HS, De Waha A, Kedhi E, Smits PC, Kaiser C, Sardella G, Marullo A, Kirtane AJ, Leon MB, Stone GW. Stent thrombosis with drug-eluting and bare-metal stents: evidence from a comprehensive network meta-analysis.Lancet. 2012; 379:1393–1402.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails February 12, 2013Vol 127, Issue 6 Advertisement Article InformationMetrics © 2013 American Heart Association, Inc.https://doi.org/10.1161/CIRCULATIONAHA.112.145169PMID: 23534060 Originally publishedFebruary 12, 2013 PDF download Advertisement
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