Comparative Effectiveness of Multivessel Coronary Artery Bypass Graft Surgery and Multivessel Percutaneous Coronary Intervention

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LettersSeptember 17, 2013Comparative Effectiveness of Multivessel Coronary Artery Bypass Graft Surgery and Multivessel Percutaneous Coronary InterventionMark A. Hlatky, MD and Derek B. Boothroyd, PhDMark A. Hlatky, MDFrom Stanford University School of Medicine, Stanford, California.Search for more papers by this author and Derek B. Boothroyd, PhDFrom Stanford University School of Medicine, Stanford, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-6-201309170-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Propensity score analysis adjusts only for measured confounding factors, and we agree with Dr. Kumasawa and colleagues that unmeasured confounders can affect estimates of treatment effectiveness. However, a major focus of our study was to show heterogeneity of treatment effectiveness due to key clinical factors and how this could lead to greatly different changes in mortality. Imbalances in unmeasured factors are unlikely to explain the significant variation in treatment effectiveness that we found related to measured factors. Also of note, analyses of data from randomized trials (1), which balance both measured and unmeasured factors, show the heterogeneity of ...Reference1. Hlatky MA, Boothroyd DB, Bravata DM, Boersma E, Booth J, Brooks MM, et al. Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials. Lancet. 2009;373:1190-7. [PMID: 19303634] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Stanford University School of Medicine, Stanford, California.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1564. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparative Effectiveness of Multivessel Coronary Bypass Surgery and Multivessel Percutaneous Coronary Intervention Mark A. Hlatky , Derek B. Boothroyd , Laurence Baker , Dhruv S. Kazi , Matthew D. Solomon , Tara I. Chang , David Shilane , and Alan S. Go Comparative Effectiveness of Multivessel Coronary Artery Bypass Graft Surgery and Multivessel Percutaneous Coronary Intervention Junji Kumasawa , Noriaki Kurita , and Shunichi Fukuhara Metrics September 17, 2013Volume 159, Issue 6Page: 435KeywordsCoronary arteriesFactor analysisPercutaneous coronary interventionStable coronary artery diseaseSurgery ePublished: 17 September 2013 Issue Published: September 17, 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...