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Off-Label Use of Drug-Eluting Stents—Reply
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In Reply: In response to Dr Bobba and colleagues, of the 6993 patients in the D.E.S.cover registry who received drug-eluting stents, 1009 (14.4%) had stable angina as the indication for PCI. In our analysis of 5541 patients who received drug-eluting stents only and could be classified by type of use, 5515 had complete data on medical therapy at discharge (Table). These data indicate in real-world clinical practice relatively aggressive but not uniform post-PCI medical therapy that does not vary appreciably by off-label vs standard use of drug-eluting stents.
Table appears in full text version.
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Table. Patients With Complete Data on Medical Therapy at Discharge (N=5515)
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Regarding the COURAGE trial reported by Boden et al,1 we note that multiple previous studies have demonstrated that medical therapy, PCI, and coronary artery bypass graft surgery yield similar long-term rates of death and myocardial infarction in stable CAD.2-4 Therefore, the conclusions of COURAGE have been previously incorporated into . . . [Full Text of this Article]
Nirat Beohar, MD
n-beohar@northwestern.edu
Charles J. Davidson, MD
Northwestern University Feinberg School of Medicine
Chicago, Illinois
Kevin E. Kip, PhD;
Helen A. Vlachos, MS
University of Pittsburgh Graduate School of Public Health
Pittsburgh, Pennsylvania
David O. Williams, MD
Brown University School of Medicine
Providence, Rhode Island
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RELATED LETTER
Off-Label Use of Drug-Eluting Stents
Ravi K. Bobba, Madhavi Bollu, and Edward L. Arsura
JAMA. 2007;298(8):859.
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