200 e-Letters

published between 2007 and 2010

  • Family history of premature coronary heart disease and risk prediction
    M. Adnan Nadir

    We read the article by Sivapalaratnam and colleagues with great interest. Although, self-reported family history of coronary heart disease (CHD) was an independent risk factor for future CHD events in this study, the addition of family history of CHD to Framingham Risk Score (FRS) failed to improve the overall risk prediction of future CHD events. Since age is a heavily weighted risk factor incorporated in the contempora...

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  • GRACE risk recommendations in NICE GC94 are not appropriate
    Elved B Roberts

    To the Editor,

    The article by Gray et al is a succinct and useful summary of NICE clinical guidance 94 on the management of unstable angina and non ST elevation myocardial infarction (1). The NICE document is itself a major piece of work which synthesises vast bodies of evidence (2). The majority of the document and the resulting summary to which we respond are to be applauded. However, we believe the risk stra...

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  • A Single Level of Plasma Troponin-I Predict Left Ventricular Remodeling after Primary Angioplasty
    Gen-Min Lin

    To the Editor: We appreciate the work by Hall?n et al. which reported a single-point measurement of cardiac troponin-I (cTnI) 24- or 48-hours after primary angioplasty for those with ST-segment elevation myocardial infarction (STEMI) provides substantial prognostic information on the evolution of left ventricular (LV) function and the risk of LV expansion.(1) Actually, a single level of cTnI after primary angioplasty is...

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  • QRISK2 (2010) - the key issue is ethnicity and extent of reallocation
    Julia Hippisley-Cox

    In their recent paper[1], the authors describe the performance of ASSIGN and Framingham algorithms in comparison to the original QRISK equations.

    Readers may be interested that the QRISK2 algorithm was published in February 2009[2] and made available as free open source software in April 20103. This can be found at http://svn.clinrisk.co.uk/opensource/qrisk2/. The open source is intended to further increase the...

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  • Diagnosis of heart failure in primary care: the syndrome and the spectrum
    Claudia Fotzeu
    To the Editor: I read with great interest the article by Hobbs et al. [1] I commend the authors for their original review of the diagnosis of heart failure in primary care. Heart failure as defined by current guidelines published by professional societies in North America[2] and Europe[3] is a syndrome in which patients must have both typical signs and symptoms of heart failure and objective evidence of structural or functional a...
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  • Short term effects of transcatheter aortic valve implantation
    David Cunningham

    I read with interest the paper by Gotzmann and colleagues [1] demonstrating some very important differences after TAVI, particularly improvements in exercise tolerance and quality of life. I did have some reservations however on the statistical methodology that the group employed. The study involved a cohort of 44 patients, assessed before and after TAVI, so clearly paired statistical tests are appropriate. However, the...

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  • Cardiac Image Training - the 2010 Curriculum
    Jim A Hall

    Having read the appeal for a 'new dawn in imaging training' I suspect that Rajani et al have not read the current UK cardiology training curriculum (www.jrcptb.org.uk/specialties/ST3- SpR/Documents/2010%20Cardiology%20Curriculum.pdf) and appreciated the flexibility and options open to trainees and their trainers It is factually incorrect to state that UK trainees 'only appear to be able to obtain "in-program" experience i...

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  • The dangers of mandating policy in the absence of clear evidence
    Morton Satin

    It is quite incredible how far the notion of a population-wide benefit accruing from salt reduction has gone in view of the contradictory clinical evidence. In the first instance we know that the population response to salt reduction is rather limited (2-6 mm Hg) and heterogeneous, with 30% experiencing a small drop in BP, about 20% experiencing an increase in BP and the residual 50% o the population undergoing no impac...

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  • Clinical applications of two dimensional speckle tracking
    Rhys P Beynon

    Dear Sir,

    I read with interest Blessberger and Binder's article on the clinical applications of two dimensional speckle tracking following their excellent previous article detailing the technique's basic principles[1, 2]. The two articles carry significant detail but fall down in one major regard. Whilst the authors state that the reproducibility of speckle tracking is greater than tissue Doppler imaging (TDI), at...

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  • Is the gender an authentic risk factor for aortic valve replacement in severe aortic stenosis?
    Juan Caballero-Borrego

    We would like to congratulate the authors for the paper about gender differences in aortic valve replacement (AVR) in severe aortic stenosis (SAS)(1). Traditionally there have been mortality perioperatory differences depending of the gender (2), and these differences have been included in operatory risk calculators. In this work, the authors do not find differences in mortality between men and women. Our attention on the...

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