197 e-Letters

published between 2006 and 2009

    Dr.Srikanth .S Achanta

    It is known fact that emergency physicians misdiagnose heart failure in about 40% cases and these patients have high mortality rate of around 21%.The novel biomarkers like BNP assay significantly improves the accuracy of diagnosis of acute heart failure in patients presenting to the emergency department with dyspnea. The cut off point of 100 pg/ml, BNP has a sensitivity of 90% in isolation of clinical factors but the speci...

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  • Correct management, Incorrect rationale.
    Ralph G. Oriscello

    It was with great interest and enthusiasm that we read the recent "Images in Cardiology" presentation of Drs. Magapu and Newall. Without commenting on the eventual neurologic status of their patient, resuscitated for 45 minutes, followed by a prolonged stay in the Intensive Care Unit, most likely tethered to a ventilator, they concluded that the final therapy to prevent a recurrence was the insertion of an implantable c...

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  • RE: Non-Cardiac Surgery and Anti-Platelet Therapy Following Coronary Artery Stenting
    Luca Carmignani

    We read with great interest the work by Luckie et al, We read with great interest the work by Luckie et al., recently published in this Journal.1 There is an emerging problem of patients who have recently undergone coronary artery stent placement who then require noncardiac surgical interventions. This occurs in approximately 5% of the cases within 12 months of the stent placement.2 Coronary artery stenting is followed by a p...

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  • Response to –‘Immediate versus deferred Coronary Angioplasty in non-ST-elevation ACS
    Abhishek Kumar

    Dear Editor, Riezebos et al.1 should be commended for trying to define the optimal timing of early coronary intervention (PCI) in patients with non-ST elevation acute coronary syndrome (ACS), an area that lacks robust evidence. However, we believe there are some deficiencies in this study that may alter the conclusions. Although the recruitment was done at ‘Three high Volume Centres’, the slow recruitment and small populati...

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  • n-3 polyunsaturates are still underappreciated and underused post myocardial infarction
    Paul Greene

    To the editor

    It was with great interest that we read the contribution by Khavandi and colleagues (1) on Omega 3 fatty acids being under-appreciated and underused post myocardial infarction. We welcome their timely reminder of the evidence on Omega 3. However we feel that some of their comments regarding implementation of NICE guidance are at odds with our local experience. They argue that pharmacotherapy was d...

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  • Chris P. Gale

    To the editor. We read with interest the paper presented by Breiger et al [1] and feel that it is most worthy of comment. The authors describe the development and internal validation of a risk score for patients with NSTEACS, from a global registry, that predicts in-patient freedom-from- events. They present an alternative concept to ACS risk characterisation – rather than the identification of high-risk subjects who merit...

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  • Exercise and Adult Congenital Heart Disease
    Jaspal S Dua

    The Editor, Heart Heart Editorial Office BMJ Journals Department, BMA House Tavistock Square London WC1H 9JR, UK Email: heartjournal@bmjgroup.com; Tel: +44 (0)20 7383 6235

    Dear Sir,

    We read with interest, the editorial by Jelinek [1] on exercise as a neglected risk factor and treatment in coronary artery disease. The studies by Stamatakis et al [2] and Redfern et al [3] emphasize the importance of...

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  • Response to Ni et al. (Heart Online, Jan 19th, 2009)
    Christopher L Jackson

    Dear Editor,


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  • Elderly recurrent fallers with carotid sinus hypersensitivity and pacing
    Monica Solbiati


    we read with great interest the article by Parry and co-workers regarding pacing in elderly recurrent fallers with carotid sinus hypersensitivities (1). However, we believe that there are some issues deserving clarification.

    We wonder whether the results of the study could have been influenced by a patients’ selection different than other studies. This hypothesis could be supported by the 11,7% mo...

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  • Risk of Bias in Meta-analysis on Erythropoietin-stimulating Agents in Heart Failure
    Benjamin P. Geisler

    To the editor: We are delighted by the encouraging results reported in van der Meer et al.'s meta-analysis [1] regarding lower hospitalization rates of erythropoiesis-stimulating agents (ESAs) in heart failure (HF). However, the possibility of bias in the studies included in the meta- analysis might be greater than assessed by the authors.

    First, the methodological quality of the reviewed studies was limited accor...

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