eLetters

761 e-Letters

  • Complete vs Culprit-only Revascularization for Patients with ST-Segment Elevation Myocardial Infarction
    RAHMAN SHAH
    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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  • Multiple authors and affiliations

    Atrial fibrillation (AF) constitutes a major risk factor for stroke and death.1 ,2 The potential of biomarkers to improve the prognostication concerning stroke and other cardiovascular events in patients with AF is gaining strength of evidence and clinical promise. In particular the biomarkers of cardiovascular stress and dysfunction such as cardiac troponin (cTn), a marker of myocardial cell damage; N-terminal B-type natriuretic peptide (NT-proBNP), a marker of cardiac dysfunction; and growth-differentiation factor-15 (GDF-15), a marker of inflammation and oxidative stress, have been shown to be strong independent predictors.3–8 Although inflammatory activation has been linked to the occurrence of AF and to a prothrombotic state, the association with subsequent cardiovascular events during treatment with oral anticoagulation has not been fully established.9–14 Prior studies evaluating the relation between inflammation and cardiovascular events in patients with AF have often been exploratory and did not take into account the protective effect of oral anticoagulation. In addition the associations with outcomes have not been fully adjusted for other risk indicators, in particular other cardiovascular biomarkers, which recently have show

  • new title because the other one disappeared

    Atrial fibrillation (AF) constitutes a major risk factor for stroke and death.1 ,2 The potential of biomarkers to improve the prognostication concerning stroke and other cardiovascular events in patients with AF is gaining strength of evidence and clinical promise. In particular the biomarkers of cardiovascular stress and dysfunction such as cardiac troponin (cTn), a marker of myocardial cell damage; N-terminal B-type natriuretic peptide (NT-proBNP), a marker of cardiac dysfunction; and growth-differentiation factor-15 (GDF-15), a marker of inflammation and oxidative stress, have been shown to be strong independent predictors.3–8 Although inflammatory activation has been linked to the occurrence of AF and to a prothrombotic state, the association with subsequent cardiovascular events during treatment with oral anticoagulation has not been fully established.9–14 Prior studies evaluating the relation between inflammation and cardiovascular events in patients with AF have often been exploratory and did not take into account the protective effect of oral anticoagulation. In addition the associations with outcomes have not been fully adjusted for other risk indicators, in particular other cardiovascular biomarkers, which recently have showed to be independent and powerful markers of adverse outcomes in patients with AF.4 In this predefined biomarker study within the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial we asse...

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  • this is a title for beta testing

    beta testing beta testing

  • Assessing effect of remote ischaemic preconditioning on clinical outcomes in patients undergoing cardiac bypass surgery
    Wei Zhang

    Assessing effect of remote ischaemic preconditioning on clinical outcomes in patients undergoing cardiac bypass surgery

    To the Editor : In a recent article of Candilio et al.1 assessing the effect of remote ischaemic preconditioning (RIPC) on postoperative outcomes in patients undergoing cardiac surgery, they showed that RIPC reduced the amount of perioperative myocardial injury by 26% and the incidence of acute...

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  • Causes of sleep deprivation in cardiac patients in hospital settings
    Tanu Pramanik
    Tanu Pramanik Senior Lecturer (Psychology) Effect of sleep deprivation on cardiac patients is an well documented clinical entity which the authors of the current article established with experimental data and therefore deserve sincere applause(1). WHO guideline: The World Health Organization guidelines say that for a good sleep, sound level should not exceed 30 dB(A) for continuous background noise, and 45 dB(A) for individual no...
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  • Response to the letter regarding the article "Early beta-blocker use and in-hospital mortality in patients with Takotsubo cardiomyopathy"
    Toshiaki Isogai

    We would like to thank Professor Madias for his comments and interest in our study.[1] We appreciate the editors of Heart for giving us the opportunity to reply. The Diagnosis Procedure Combination database in Japan contains hospital administrative claims data and discharge abstracts representing approximately 50% of all inpatient admissions to acute-care hospitals in Japan.[2] As per the request by Professor Madias, we...

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  • Takotsubo syndrome in a Japanese patient cohort: an opportunity to tap into a great resource!
    John E. Madias

    To the Editor: The report by Isogai al,1 published online ahead of print on February 15, 2016 in the Journal, about the 2672 patients (81.5% women) who had suffered Takotsubo syndrome (TTS) between 2010 and 2014, deriving from the "Diagnosis Procedure Combination nationwide inpatient database in Japan" is an invaluable resource, since it comprises all patients with this pathology admitted to acute-care hospitals in the en...

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  • Diabetogenic effect of statins is difficult to ignore.
    Dr.Rajiv Kumar
    Authors mentioned, that meta-analysis include both published and unpublished data from randomised controlled trials (this remove bias of selective clinical trial reporting), and results were regardless of background statin or combination laropiprant therapy ( to maintain clarity, and or to remove confusion with regards to results). 34% higher risk of developing diabetes was reported with Niacin therapy and new-onset diabetes i...
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  • Diastolic function
    Philip A Smith

    Having scanned many a patient with pacemakers in the presence of new algorithms which allow significant AV delays (essentially P-R) prolongation, I have noticed that due to the timings, long P-R can cause truncation of diastolic filling time (E:A fusion). This will significantly impact the preload of the LV, reduce stroke volume and may even impact on coronary filling. I am unsure why this would increase the risk of AF bu...

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