176 e-Letters

published between 2013 and 2016

  • The role of FFR in clinical practice
    Marco Araco

    Only recently the FAME-2 trial1 showed for the first time that, in patients with stable coronary artery disease (SCAD) and "significant" myocardial ischemia, there is a prognostic advantage of PCI over optimal medical therapy (OMT), and that this advantage is consistent in patients with either single or multi-vessel coronary artery disease. The clinical outcome of patients with coronary stenoses not associated with signi...

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  • Effects of remote ischemic preconditioning on clinical outcomes after cardiac surgery
    Fu-Shan Xue

    In recent article of Candilio and colleagues assessing effect of remote ischemic preconditioning (RIPC) on postoperative outcomes in patients undergoing cardiac surgery, they showed that RIPC reduced amount of perioperative myocardial injury by 26% and incidence of acute kidney injury by 48%, respectively. They should be applauded for trying to control most of risk factors affecting postoperative myocardial and kidney in...

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  • Re:Physical Activity and Cardiorespiratory Fitness as Underappreciated Modulators of Obesity-Related Risk of Sudden Cardiac Death
    Selcuk Adabag
    We thank Laukkanen et al. for their interest in our recent report titled "Obesity related risk of sudden cardiac death in the Atherosclerosis Risk in Communities (ARIC) study" (1). We agree that regular moderate physical activity reduces the risk of sudden cardiac death (SCD) and all-cause mortality. Physical activity, but not fitness, was captured in the ARIC study via questionnaires. However, adjustment for this variable in our...
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  • NICE guidance for the investigation of recent-onset chest pain
    Adam Timmis

    The paper by Patterson et al (1) illustrates why the NICE and ESC guidelines (2,3) recommend no non-invasive testing in patients presenting with undifferentiated chest pain in whom a non-cardiac cause is suspected or the probability of coronary artery disease (CAD) is judged to be very low (NICE <10%, ESC <15%). Table 5 shows there were 351 such patients, of whom 24 were subsequently diagnosed with CAD. Even if we...

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  • What about the actual history of the chest pain
    Justin Zaman

    I am rather surprised that the authors did not take into account more clinical features of the history in their model.(1) Pleuritic features and relief when sat up suggest pericarditis, whilst there are of course specific features that suggest reflux oesophagitis; timing is important, as pain lasting less than a minute is really not suggestive of ischaemic disease.

    The authors state 'we included consenting adults...

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  • what was the prevalence of concordant ST segment deviation in type 1 AMI with LBBB?
    oscar,m jolobe

    The 6.3% prevalence of left bundle branch block(LBBB) among 17,488 subjects with type 1 acute myocardial infarction(AMI) translates into 1101 subjects with this manifestation of AMI(1). This represents a golden opportunity to document the prevalence of concordant ST segment deviation in those 1101 subjects so as to enable a comparison to be made with the study which reported a low prevalence of acute coronary occlusion in...

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  • manchseter medical society
    oscar,m jolobe

    The documentation of a rising incidence of cardiac resynchronisation therapy(CRT)-related infection(1) calls for a reappraisal of the Class 1 level A recommendation for the use of this modality(2), given the fact that the recommendation antedated the ground breaking introduction of angiotensin-neprilysin inhibition in subjects with comparable severity of systolic heart failure(3). In that study a significant(p < 0.00...

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  • Physical Activity and Cardiorespiratory Fitness as Underappreciated Modulators of Obesity-Related Risk of Sudden Cardiac Death
    Jari A Laukkanen

    We read with great interest the recent report, published in Heart, entitled "Obesity related risk of sudden cardiac death in the Atherosclerosis Risk in Communities (ARIC) study" by Adabag et al.1 Among a large cohort of middle-aged adults (n = 14,491 African American and white men and women; 55% female), baseline measures of obesity, including body mass index (BMI), waist circumference (WC), and waist-to- hip ratio (W...

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  • Comment on: An epidemiological appraisal of the association between heart rate variability and particulate air pollution: a meta-analysis
    Stephane Buteau

    We believe that we have identified a methodological issue related to the procedure that Pieters et al. [1] used to combine studies using different types of regression models. In some studies heart rate variability parameters were modeled as a linear model but in others they were modeled as log-linear (i.e., where the outcome was log-transformed). To combine effect estimates from these two types of models, the authors co...

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  • Re:Correspondence: sudden death is associated both with epilepsy and with use of antiepileptic medications
    Abdennasser Bardai

    To the Editor,

    We thank the authors for their letter. The question is raised whether our study is able to distinguish between the effect of using antiepileptic medications (AEMs) and epilepsy on SCD risk. We studied SCD risk among AEM users (with and without epilepsy).1 We show in multiple ways that AEM use increases SCD risk, independently from epilepsy and other confounders. Notably, SCD risk in non-epilepsy pa...

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