Response by Pasupathy et al to Letters Regarding Article, “Early Use of N-acetylcysteine (NAC) With Nitrate Therapy in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction Reduces Myocardial Infarct Size (The NACIAM Trial [N-Acetylcysteine in Acute Myocardial Infarction])”
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We appreciate the correspondence concerning the NACIAM trial (N-acetylcysteine in Acute Myocardial Infarction),1 which focused on the study analytical methods and potential mechanisms contributing to the benefits of N-acetylcysteine (NAC)/nitroglycerin use in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.
Ye et al commented on the study analytical methods, raising concerns as to whether (1) propensity score matching between study groups is required, (2) repeated measures ANOVA should be undertaken in the chest pain and creatine kinase (CK) analyses, and (3) a curvilinear relationship exists between infarct size and the predictive clinical variables so that a generalized linear model analysis would be more appropriate. First, concerning study group matching, the groups were balanced in this randomized controlled trial of consecutive eligible patients so that propensity analysis is not required, particularly in light of the limitations of this analytic approach.2 Second, repeated measures ANOVA is appropriate and was conducted for the chest pain analysis, but the …