A Decade of Improvement in the Clinical Outcomes of Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease
To the Editor:
We appreciate the editorial by Drs Popma, Kuntz, and Baim1 highlighting the recently published comparison of the National Heart, Lung, and Blood Institute Dynamic Registry and the Bypass Angioplasty Revascularization Investigation (BARI) study.2 In particular, it is gratifying to have them recognize the value of “real-world” registries such as the Dynamic Registry.
We would like to correct two items reported in that editorial.
(1) Although it is true that BARI utilized an angiographic core laboratory, only clinical site readings were used for both the BARI patients and the Dynamic Registry patients to appropriately compare the two studies.
(2) As Popma et al noted, it would be surprising for the frequency of periprocedural myocardial infarction (MI) to remain unchanged between BARI (1988 to 1991) and the Dynamic Registry (1997 to 1999).1 In fact, as we reported “the incidence of in-hospital MI (0.8% versus 2.1%, P=0.025) was significantly lower in the Dynamic Registry.”2
Popma JJ, Kuntz RE, Baim DS. A decade of improvement in the clinical outcomes of percutaneous coronary intervention for multivessel coronary artery disease. Circulation. 2002; 106: 1592–1594.
Srinivas VS, Brooks MM, Detre KM, et al. Contemporary percutaneous coronary intervention versus balloon angioplasty for multivessel coronary artery disease: a comparison of the National Heart, Lung and Blood Institute Dynamic Registry and the Bypass Angioplasty Revascularization Investigation (BARI) study. Circulation. 2002; 106: 1627–1633.