Lean tissue adjusted peak oxygen consumption in congestive heart failure.

We disagree with the comments made by Dr. F. James Brennan that major events were underreported in our recent Journal article (1). Although we used a composite end point that included death, myocardial infarction, cerebrovascular accident and myocardial revascularization, we also separately reported mortality, myocardial infarction, repeat revascularization procedures and stroke (1). For example, as outlined in the Results section, there were thirteen 30-day deaths in the coronary artery bypass graft (CABG) group and two deaths in the percutaneous transluminal coronary revascularization (PTCR) group. After one month, five patients died in the PTCR group and four in the CABG group. These deaths are reflected in the Kaplan-Meier survival curves shown in our Figure 2, demonstrating a better survival in the PTCR group compared with CABG group (96.9% vs. 92.5%, respectively, p , 0.017). We employed the Kaplan-Meier method to estimate length of survival, freedom from myocardial infarction, freedom from repeat revascularization procedures and freedom from combined events for patients treated with CABG and with PTCR (see our Figs. 2–4). Comparison between groups was performed using the log-rank test. The Kaplan-Meier method is an appropriate means of estimating survival and other major events in our study. Because each of the events (mortality, myocardial infarction and repeat revascularization procedures) was analyzed separately using the Kaplan-Meier method, there was no under-reporting of major events. Although a given patient may have experienced a nonfatal primary end point, he or she was not excluded from the analysis of the other events. The Kaplan-Meier method allows the estimation of survival time of each patient who dies and provides exact survival proportions; this is because it uses exact survival times. The same principle was applied in the calculation of freedom from myocardial infarction and freedom from repeat revascularization procedures.