760 e-Letters

  • Response: A novel troponin I rule-out value below the upper reference limit for acute myocardial infarction
    Andrew R. Chapman

    To the Editor,

    Goorden et al aim to establish the optimal threshold to rule out myocardial infarction using a high-sensitivity cardiac troponin I assay. They report that a cardiac troponin I concentration <10 ng/L or a change of <20 ng/L on serial testing had a negative predictive value for the diagnosis of myocardial infarction of 99.8% and 98.7% respectively [1]. Whilst we agree there are better appro...

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  • Regarding sex differences in cardiovascular ageing: let's not forget iron
    Mark R. Goldstein

    The interesting paper of Merz and Cheng did not mention iron as a plausible non-hormonal factor, which might in part explain the sex differences in cardiovascular aging [1].

    Mounting evidence suggests that the metabolic derangements and detrimental cardiovascular effects usually attributed to menopause represent only a mere consequence of the older age of menopausal women, rather than related to the loss of ov...

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  • Author Reply: Sex Differences in Cardiovascular Ageing
    Susan Cheng

    We thank Dr. Goldstein for bringing to our attention the iron hypothesis as a potential non-hormonal factor contributing to sex differences in cardiovascular aging. We also find intriguing the possibility that iron depletion in menstruating women may be cardio- protective. We had previously been aware of the potential role of iron as a byproduct of heme-oxygenase activity in mediating cardiometabolic risk,[1] with a numb...

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    Testing article responses 2

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    Testing article responses

  • The enigma of high adiponectin levels and adverse outcomes in older people: a consequence of proinflammatory state and autoimmune activation?
    Altan Onat

    The excellently analyzed paper from the Cardiovascular Health Study on higher circulating adiponectin being associated with elevated risk of atrial fibrillation (AF) in the elderly [1), calls for focusing attention on this and analogous paradoxical manifestations accumulating in the medical literature. The investigation by Macheret and associates involved 886 incident AF events in a cohort of older -predominantly female-...

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  • Carotid Artery Stenting Outcomes in Dataset Registries: A Cause of Concern or an Opportunity for Improvement?
    A. Ross Naylor

    Roffi et al.1 report that contemporary outcomes following carotid stenting (CAS) in large-scale registries were comparable to carotid endarterectomy (CEA). They also concluded that, over time, complication rates following CAS had decreased.1

    We recently reviewed outcomes after >1,500,000 procedures in 21 administrative dataset registries where procedural death/stroke rates were reported for both CEA and CAS....

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  • Complete multivessel revascularization in STEMI. Reply to the letter by Shah et al.
    Eliano Navarese

    To the Editor:

    We read with interest the letter by dr Shah [1] regarding our recent meta-analysis: "Complete revascularisation in ST-elevation myocardial infarction and multivessel disease: meta-analysis of randomised controlled trials" [2]. The meta-analysis was designed to compare complete multivessel PCI (MV-PCI) with non-complete MV-PCI in ST-elvation myocardial infarction (STEMI) and MV disease. Complete MV...

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  • This is a response on a different date

    ALICE was beginning to get very tired of sitting by her sister on the bank and of having nothing to do: once or twice she had peeped into the book her sister was reading, but it had no pictures or conversations in it, "and what is the use of a book," thought Alice, "without pictures or conversations?'
    So she was considering, in her own mind (as well as she could, for the hot day made her feel very sleepy and stupid), whether the pleasure of making a daisy-chain would be worth the trouble of getting up and picking the daisies, when suddenly a White Rabbit with pink eyes ran close by her.
    There was nothing so very remarkable in that; nor did Alice think it so very much out of the way to hear the Rabbit say to itself "Oh dear! Oh dear! I shall be too late!" (when she thought it over afterwards it occurred to her that she ought to have wondered at this, but at the time it all seemed quite natural); but, when the Rabbit actually took a watch out of its waistcoat-pocket, and looked at it, and then hurried on, Alice started to her feet, for it flashed across her mind that she had never before seen a rabbit with either a waistcoat-pocket, or a watch to take out of it, and burning with curiosity, she ran across the field after it, and was just in time to see it pop down a large rabbit-hole under the hedge.

  • Complete vs Culprit-only Revascularization for Patients with ST-Segment Elevation Myocardial Infarction
    To the Editor: We read with great interest the recent meta-analysis by Kowalewski et al.[1] The authors should be congratulated for their work. However, we would like to make few comments about some issues with the meta-analysis. First, complete revascularizations (CRs) done as staged procedures (SPs) were analyzed with the incomplete revascularization group, but endpoints were measured at a median follow-up of 12 months. Becaus...
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