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Prognostic Implications of Elevated Creatine Kinase After Coronary Angioplasty-Reply

Prognostic Implications of Elevated Creatine Kinase After Coronary Angioplasty-Reply In Reply. —Dr Densem expressed concern that the case and control groups were not matched. He states that late cardiac mortality could therefore be influenced by potential demographic or procedural imbalance. We wish to emphasize several points in this regard. First, the groups were evenly matched with regard to the major determinants of survival in coronary heart disease: age, sex, extent of coronary artery disease, and left ventricular function. The groups were also matched regarding the number of interventions performed, the devices used, and the month and year of the procedure. This latter aspect we believe is particularly important, as operator experience impacts on procedural success and complication rates. It is also well established that saphenous vein graft interventions are associated with a higher incidence of distal embolization.1 Therefore, any study of consecutive patients undergoing percutaneous transluminal coronary angioplasty will likely have a greater incidence of CK release with bypass graft http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Prognostic Implications of Elevated Creatine Kinase After Coronary Angioplasty-Reply

Kong, Thomas Q.; Davidson, Charles J.
JAMA , Volume 277 (20) – May 28, 1997
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Prognostic Implications of Elevated Creatine Kinase After Coronary Angioplasty-Reply

Abstract



In Reply.
—Dr Densem expressed concern that the case and control groups were not matched. He states that late cardiac mortality could therefore be influenced by potential demographic or procedural imbalance. We wish to emphasize several points in this regard.
First, the groups were evenly matched with regard to the major determinants of survival in coronary heart disease: age, sex, extent of coronary artery disease, and left ventricular function. The groups were...
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Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.1997.03540440027021
Publisher site
See Article on Publisher Site

Abstract

In Reply. —Dr Densem expressed concern that the case and control groups were not matched. He states that late cardiac mortality could therefore be influenced by potential demographic or procedural imbalance. We wish to emphasize several points in this regard. First, the groups were evenly matched with regard to the major determinants of survival in coronary heart disease: age, sex, extent of coronary artery disease, and left ventricular function. The groups were also matched regarding the number of interventions performed, the devices used, and the month and year of the procedure. This latter aspect we believe is particularly important, as operator experience impacts on procedural success and complication rates. It is also well established that saphenous vein graft interventions are associated with a higher incidence of distal embolization.1 Therefore, any study of consecutive patients undergoing percutaneous transluminal coronary angioplasty will likely have a greater incidence of CK release with bypass graft

Journal

JAMA – American Medical Association

Published: May 28, 1997

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