147 e-Letters

published between 2010 and 2013

  • Preoperative Beta-blockade: Unanswered Questions
    Steven L. Cohn

    While I agree for the most part with the comments of Bouri et al[1] in their recent meta-analysis of preoperative beta-blockade, I believe the answers to a number of questions are not in, and the authors failed to highlight some important points. None of the "secure" trials started beta- blockers more than a day before surgery nor did they titrate the dose to control heart rate. The authors did not focus on the timing aspe...

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  • Greater scientific rigour required for all dietary sodium studies related to health outcomes.
    Morton Satin

    The recent article by Jun and Neal (1), "Low dietary sodium in heart failure: a need for scientific rigour," calls for greater consistency and attention in one outcome related to salt intake. The Salt Institute is in complete agreement with their call for greater scientific rigour and believes, in the interests of public health, that this should be extended to all health outcomes related to dietary sodium intake. While...

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  • Drug-eluting balloon for in-stent restenosis
    Shilian Hu

    Drug-eluting balloon for in-stent restenosis

    Yin Chen, Shilian Hu, Lei Wu

    To the Editor: We read with interest the meta-analysis by Indermuehle A et al which reported that drug-eluting balloon (DEB) appears to show great promise for in-stent restenosis (ISR), and could reduce the risk for major adverse cardiac events (MACE) compared with plain balloon angioplasty (BA)or implantation of drug-eluting stent...

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  • Cholesterol as a statin indication
    Paul Durrington

    This article contains some valuable information, but is misleading in at least one important respect. The Joint British Societies did not recommend statin treatment when cholesterol levels are higher than 6mmol/l. Rather, they recommended that a ratio of total serum cholesterol to HDL cholesterol exceeding 6 should be an indcation. This is actually the most conservative use of lipid values as arbiters of who should recei...

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  • The significant association between apnoea-hypopnoea index and flow-mediated dilation of brachial artery: statistical consideration on its validity
    Tomoyuki Kawada

    I read with interest the cross-sectional study by Namtvedt et al. (1) for 77 adults, who were sampled from 30,000 individuals aged 30-65 years. They concluded that there was a significant positive association between obstructive sleep apnoea (OSA) and endothelial dysfunction by using indicators of apnoea-hypopnoea index (AHI), flow-mediated dilatation (FMD), sex and some cardiovascular risk factors. Atkinson made a query...

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  • Hormone Associated Spontaneus Coronary Artery Dissection
    Gonenc Kocabay

    To the Editor, We read with interest Plonczak et al's article depicting the two-vessel spontaneous coronary artery dissection(SCAD) as a cause of acute coronary syndrome(ACS)(1). SCAD is uncommon,accounting for 0.1-0.28% of all patients with ACS or sudden cardiac death.It is more common in young female patients with the average of initial presentation is 35-44 years old. Conventional coronary risk factors, such as smok...

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  • Clopidogrel Loading Dose in Patients Undergoing Elective Percutaneous Coronary Intervention
    Gen-Min Lin

    To the Editor: We read with interest the meta-analysis by Siller-Matula et al which reported that intensified clopidogrel loading with 600mg reduces the rate of major cardiovascular events without increase in major bleeding compared to 300mg in patients undergoing percutaneous coronary intervention (PCI) during one month follow-up.1 A large body of evidence have suggested the effectiveness and safety of 600-mg loading dos...

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  • Atrial reverse remodeling in super-responders to cardiac resynchronization therapy
    Gaetano Santulli

    In a recent issue of Heart1 Steffel et al. show in an elegant retrospective study that patients with an exceptionally good echocardiographic response to cardiac resynchronization therapy (CRT) are highly likely to experience a favorable outcome after CRT. We feel that this paper is worthy of comment. The study is well designed and represent an outstanding 'real world' experience. However, we do have several issues. The...

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  • Carotid plaque typization: a novel risk marker?
    Marijan Bosevski

    Toutouzas and co-authors demonstrated that carotid plaque vulnerability coincided with neovascularisation and inflammation, as measured by CEUS and MR.1 Carotid IMT and detection of stenosis have been previously established as predictor of prognosis of patients with cardiovascular disease. Carotid non-invasive measurements have been recommended in vulnerable patients, because of tight correlation between parameters: pl...

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  • Cilostazol in NICE guideline
    Sergi Bellmunt

    To the Editor,

    Shalhoub and Davies (1) commented in their summary of NICE guidance on cilostazol, naftidrofyryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication (NICE technology appraisal guidance 223; available at: www.nice.org.uk/guidance/TA223) that the cost-effectiveness analysis was based on appropriate assumptions, however, this analysis was based on a meta-anal...

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