In Reply: In response to Dr Wierzbicki and
colleagues, in the MIRACL study1 the significant
reduction of the primary composite end point with atorvastatin was influenced
most by a 26% reduction in recurrent unstable angina with objective evidence
of ischemia requiring emergency rehospitalization, a finding with obvious
clinical importance. However, it is important to note that the MIRACL study
was not powered to detect significant differences in individual components
of the primary composite end point. In fact, an 8% nonsignificant reduction
in death and nonfatal myocardial infarction with atorvastatin also contributed
to the significant reduction of the primary composite end point.
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