JAMA Internal Medicine ( IF 39.0 ) Pub Date : 2020-01-01 , DOI: 10.1001/jamainternmed.2019.5857 Cibele Larrosa Garzillo 1 , Paulo Cury Rezende 1 , Whady Hueb 1
In Reply We appreciate the questions and the opportunity to clarify the points mentioned in the letter by Erqou and colleagues. This study1 investigated whether the presence of myocardial ischemia, documented during stress testing, identified patients at higher risk for cardiovascular events or that would evolve with worsening ventricular function over 10 years of follow-up of the second Medical, Angioplasty, or Surgery Study trial. This is the cornerstone of the study. We agree that the current report is based on observational comparison, but, in fact, this is a prospective cohort study using data from a randomized clinical trial that selected a homogeneous group of patients with multivessel coronary artery disease amenable to 3 types of treatment: medical therapy, percutaneous coronary intervention, and bypass surgery.2 This homogeneity is also observed in the baseline characteristics of this current analysis.1 Thus, these factors strengthen the methodology of the current report and differentiate it from a number of other studies that evaluated the prognostic effect of stress testing.3
中文翻译:
已知症状性多支冠状动脉疾病答复患者的压力测试和风险预测。
在答复中我们感谢问题和有机会澄清Erqou及其同事在信中提到的要点。本研究1调查了在压力测试期间记录的心肌缺血的存在是否确定了发生心血管事件风险较高的患者,或者在第二次医学,血管成形术或手术研究试验的10年随访中,随着心室功能恶化而发展的患者。这是研究的基石。我们同意本报告基于观察性比较,但实际上,这是一项前瞻性队列研究,使用了一项随机临床试验的数据,该试验选择了一种均质的多支冠状动脉疾病患者组,可以接受以下三种类型的治疗:治疗,经皮冠状动脉介入治疗和搭桥手术。2在当前分析的基线特征中也观察到这种同质性。1个因此,这些因素加强了本报告的方法论,并将其与评估压力测试的预后效果的许多其他研究区分开来。3