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Re: DewDiligence post# 38679

Wednesday, 12/06/2006 12:10:54 AM

Wednesday, December 06, 2006 12:10:54 AM

Post# of 257661
In general this article is extremely poorly written. It gives the immediate impression that DES are hazardous, but then gives no data that are even remotely compelling:

The lack of a significant difference in event rate -- 9.3% for drug-eluting stents versus 7.9% for bare metal stents -- was driven by a significantly lower target vessel revascularization rate for drug eluting stents (HR 0.52, 95% CI 0.33 to 0.85, P=0.009), the authors concluded.

First, the p value for the above difference in "event" rates is >0.5.

Second, what are these "events" given that later in the same sentence they say the DES had a lower rate? (And later yet they make it implicitly clear that these above mentioned "events" are not the late-thromb rate)

When these 16 late-thrombotic events are compared with the 49 other events that occurred after Plavix was stopped, a somewhat higher-but non-significant-cardiac mortality rate emerged but the rate of nonfatal MIs was significantly higher (19% versus 6%, P=<0.0001), they wrote.

This paragraph is more than a little unclear, but I think the point of it is that of all the (MACE???) events you can have, late-thrombitic events are the more likely to result in MI. Ok, yes, .... and the point is ... . Unless they give the relative difference of the DES late-thromb rate vs the BMS late-thromb rate it doesn't mean much.


It is possible something will come to light that DES, even with good treatment (e.g. Plavix), are more lethal. But so far the data are weak. The only other randomized studies I can find point the other way inre lethality.




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