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June 4, 2003

Outcomes of Medical vs Invasive Therapy for Elderly Patients With Angina—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(21):2794. doi:10.1001/jama.289.21.2794-a

To the Editor: Dr Pfisterer and colleagues1 reported that 1 year after either invasive treatment or optimized medical therapy, elderly patients with angina had similar symptoms, quality of life, and risk of death or nonfatal myocardial infarction. In contrast with their previous report of 6-month outcomes,2 the authors now report that patients who underwent medical therapy had a higher risk of later hospitalizations for uncontrolled symptoms. The end point of hospitalization seems reasonable, even though other primary and secondary prevention studies did not use it.35 Although this makes the trial less comparable with previous results, the authors did not discuss these differences.

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