147 e-Letters

published between 2010 and 2013

  • Important cost categories not included: TAVI probably less cost-effective
    Pieter H van Baal

    Patients eligible for the TAVI intervention are old (>75), face a high mortality risk and generally have multiple comorbidities [1]. Health care consumption of this group of patients can therefore expected to be high [2,3]. As a consequence, life extension in this group would probably result in additional health care consumption in so-called life years gained. Health care consumption in life years gained could be due...

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  • "High platelet reactivity to both aspirin and clopidogrel" is indicative of a generalized high platelet reactivity phenotype
    Paul A. Gurbel

    Young-Hoon Jeong, MD, PhD,1,2 Kevin P Bliden , MBA,1 Yongwhi Park, MD, PhD,2 Udaya S. Tantry, PhD,1 Paul A. Gurbel, MD1

    1Sinai Center for Thrombosis Research, Baltimore, Maryland; and 2Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea.

    The study by Breet et al.1 supported our previous suggestion that a cutoff of aspirin reaction units (ARU)...

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  • It is usually the cigarettes that did it
    M. Justin Zaman

    It should be remembered that in INTERHEART, nine risk factors accounted for 90% of the population attributable risk of a myocardial infarction in men and 94% in women - these did not include family history.[1] Thus, on a population basis, I would disagree with the authors that 'A positive family history of premature coronary artery disease (CAD) is an important risk factor for cardiovascular disease (CVD)'. It is however...

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  • RAMIT: Making sense of its findings and flaws
    Julie Redfern

    West and colleagues'[1] recently published randomised controlled trial (RCT) exemplifies successful failure. Because and not despite of its null findings and flaws, RAMIT provides lessons for the future of prevention. Skeptics and proponents of traditional hospital-based cardiac rehabilitation (CR) should not use the study's findings or flaws to defend their respective positions but harness its failure constructively for...

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  • The future of Cardiac Rehabilitation in the UK
    Mohammed A. Rashid

    Dear Sir,

    The recent paper by West et al [1] was critiqued by the current cohort of students taking the MSc Preventive Cardiology at Imperial College London. The following opinions summarise the consensus reached in a group discussion.

    Although all programmes included were reported to conform to contemporary 1995 BACR guidelines for phase three rehabilitation, these varied markedly, as highlighted by...

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  • Exercise training as an essential component of cardiac rehabilitation.
    Viviane M Conraads

    Dear Editor,

    We read with interest, but also great concern, the paper by West, et al.1 on their multi-centre randomized cardiac rehabilitation study, suggesting negligible results. This study was covered in the Belgian press and already led to questions about further reimbursement of such multi- disciplinary programs. We agree that re-evaluation of cardiac rehabilitation in the era of early revascularisation and...

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  • Is RAMIT reflecting the real world?
    Thomas Berger

    RAMIT explored the effect of a phase II outpatient-based cardiac rehabilitation (CR) concept. The authors reported no effect on mortality, cardiac or psychological morbidity, risk factors, health-related quality of life or physical activity of a comprehensive CR programme after myocardial infarction. However, to our opinion these findings cannot be generalized and merit an in-depth critical analysis. In many European c...

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  • West et al. Rehabilitation after myocardial infarction trial (RAMIT): multi-centre randomised controlled trial of comprehensive cardiac rehabilitation in patients following acute myocardial infarction. Heart.2011 Dec 22. [Epub ahead of print]

    Dear Professor Timmis,

    We, members of the council of the British Association for Cardiovascular Prevention and Rehabilitation (BACPR), representing over 800 health professionals, strive to ensure that our guidance for cardiac rehabilitation (CR) programmes is based on best evidence. Whilst, the topic of the RAMIT study1 is a welcome one, we have significant concerns about this study and feel the authors have ma...

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  • Radial approach. Always superior?
    Krzysztof Letachowicz

    We read with great interest the article by Vink et al. evaluating the feasibility of a routine transradial approach in primary percutaneous coronary intervention (PPCI) for acute ST-segment elevation myocardial infarction. The study demonstrates that when transradial approach is used for PPCI, both very high success rates in vascular access and excellent procedural outcomes can be achieved, [1]. Unfortunately, the authors...

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  • Balloons and atrial fibrillation
    David E Ward

    This excellent short review article (1)is written by someone who has a self declared interest in the manufacturer of the "laser balloon" (Cardiofocus Inc, 500 Nickerson Road, Suite 500-200. Marlborough, Massachusetts). It is unsurprising therefore to see that he gives the cryoballoon, a rival technology, short shrift by dismissing it as "having problems". In fact there are published data showing that it is probably the...

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