Response to Letters Regarding Article, “Effect of Rosuvastatin Therapy on Coronary Artery Stenoses Assessed by Quantitative Coronary Angiography: A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound–Derived Coronary Atheroma Burden”

Abstract

We thank Dr Kaneda and Drs Sutton, Blumenthal, and Kapur for their interest and commentaries on our analysis.1 In response to Dr Kaneda’s request for sensitivity analyses, we applied the same conservative assumptions employed in the intravascular ultrasound (IVUS) analysis2 to all noncompleters and to those with ischemic events and found that statistically significant regression occurred in both percentage diameter stenosis (%DS) and minimum lumen diameter. With regard to the assessment of disease progression, as in previous quantitative coronary angiography (QCA) studies that we referenced,3 the prespecified outcome variable was the change in baseline stenoses >25%. This is very reasonable because some studies have shown that only progression of stenoses present at baseline was predictive of coronary events.4 In A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound–Derived Coronary Atheroma Burden (ASTEROID), 379 of the 507 randomized patients (75%) had both a baseline and a follow-up QCA study. Sixteen of these patients (4.2%) developed a new lesion of >25% stenosis that represented an increase of at least 20% from baseline. Of those 379 patients, the 292 (77%) with baseline …