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Comment & Response
November 11, 2020

PCSK9 Inhibition—A Tale of 2 Potential Treatment Opportunities—Reply

Author Affiliations
  • 1Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 2Deputy Editor, JAMA Cardiology
JAMA Cardiol. 2021;6(4):481. doi:10.1001/jamacardio.2020.5613

In Reply We appreciate the letter written by Lopez-Candales and Vallurupalli about our article1 and agree that caution is indicated when interpreting a post hoc analysis with a small number of events. Lopez-Candales and Vallurupalli note that aortic valve replacement could have been for endocarditis or concomitant surgical coronary revascularization. While this is an important consideration, only patients with aortic valve replacements that appeared to be for aortic stenosis were included in the analyses, and endocarditis was not listed as an adverse event for any of these patients. Concomitant coronary artery bypass grafting is also quite relevant, although the results were consistent when 9 patients who experienced a major adverse cardiovascular event, including coronary revascularization, concurrent with or prior to the aortic valve replacement were removed.1

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