Response to Letter Regarding Article, “The sPLA2 Inhibition to Decrease Enzyme Release After Percutaneous Coronary Intervention (SPIDER-PCI) Trial”

We thank Dr Krijnen and colleagues for their interest in our sPLA2 Inhibition to Decrease Enzyme Release after Percutaneous Coronary Intervention (SPIDER-PCI) study, the results of which were not suggestive of any evidence of a protective benefit of varespladib, an inhibitor of secretory phospholipase A2 (sPLA2), in reducing myocardial injury sustained after elective percutaneous coronary intervention (PCI).1 The hypothesis that varespladib might reduce myocardial injury associated with PCI arose from observations that nonemergent PCI is associated with a marked increase in blood sPLA2 levels.2 Krijnen et al suggest that our patient cohort was unsuitable for the study of the hypothesis that sPLA2 is involved in PCI-related cardiac inflammatory injury. We agree, and this was not our hypothesis. Rather, we set out to study whether or not sPLA2 inhibition would reduce the myocardial injury frequently observed after PCI in a stable elective PCI population. The observational …