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To the Editor: Dr Erne and colleagues¹ investigated the effects of percutaneous coronary intervention (PCI) compared with anti-ischemic drug therapy on major cardiac events in patients with silent myocardial ischemia verified by stress imaging. While they found that PCI reduced the long-term risk of major cardiac events, some issues need to be considered.

Complex angiographic stenosis morphology is closely associated with disease progression² and adverse clinical outcomes.³ Therefore, the definition of complex angiographic lesions in coronary angiography has prognostic importance and is necessary to manage patients with coronary artery disease (CAD). The presence of high-risk lesions may determine treatment and follow-up options to prevent adverse clinical outcomes. Although the study by Erne et al compared PCI with anti-ischemic drug therapy in patients with CAD, it did not present sufficient angiographic data concerning the atherosclerotic lesions. This makes it difficult to interpret the results.

In addition, in patients with myocardial ischemia . . . [Full Text of this Article]

Nihat Kalay, MD
nihatkalay@hotmail.com
Department of Cardiology
Sorgun State Hospital
Yozgat, Turkey

Ibrahim Ozdogru, MD
Department of Cardiology
Erciyes University School of Medicine
Kayseri, Turkey

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