eLetters

887 e-Letters

  • Re:The role of Left Ventricle in the Autograft Complication after ROSS operation
    Giovanni Battista Luciani

    We thank the Authors for the careful analysis of our work and the kind comments. In general, a distinction needs to be made when analysing clinical outcome after the Ross procedure in paediatric age. Whereas the neonatal and infant population generally presents with either isolated (often recurrent) or complex, multilevel LVOTO, which may be associated with mitral valve disease and varying degrees of LV hypoplasia, the...

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  • Re:Effect of incomplete revascularization
    Christos Bourantas

    Unfortunately, data with regards the presence of incomplete revascularization was available only in the Syntax study and thus this variable was not inserted in the multivariate model. Besides the aim of this analysis was to assess for clinical and anatomical variables that are available before percutaneous coronary intervention and are independent predictors of worse outcomes, since these variables can be used to stratif...

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  • Have I missed something here?
    David E Ward

    Am I missing something here? It is generally accepted that the omission of a single dose of dabigatran, which has a short elimination half-life, may place a patient at risk of thromboembolism. So why should atrial fibrillation ablation be any different especially when one is potentially stimulating thrombus formation in the left atrium during and possibly after the procedure? Why not continue the drug through the proced...

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  • Re:Have I missed something here?
    Aref A. Bin Abdulhak

    Peri-ablation dabigatran in atrial fibrillation: not only about thromboembolism.

    We have read with interest the letter by Ward (1) about our recent publication (2). The author raised an important point: why should dabigatran be interrupted during a procedure known to be associated with risk of thromboembolic events? Ward also noted that our meta-analysis did not include any study with uninterrupted dabigatran....

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  • Re:Re:Effect of incomplete revascularization
    Akshay K. Mehta

    Thank you for your response. However, since lesion calcification influenced incomplete revascularization, it would have been interesting to note its effect independant of incomplete revascularization on PCI outcomes.

    Conflict of Interest:

    None declared

  • Potential weakness of the metanalysis
    Luis Carlos Saiz

    Dear Editor,

    I have read with interest your metanalysis on effects of antihypertensive treatment in patients over 65 years of age, and I would like to point to an issue quite relevant on my view. I have checked some of the trials included because I doubted if it was possible to the authors to separate participants with more than 65 years from younger, excluding the latter from the analysis. For instance, in the...

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  • "Type 2" myocardial infarction: Evidence-based or guesswork diagnosis
    Shams Y-Hassan

    I read with great interest the recently published article by the authors Baron et al [1] on October 20, 2014 in the journal ahead of print regarding "type 2" myocardial infarction (MI) in clinical practice. One of the important findings in this large study is the outsized variation in the incidence of "type 2" MI between the reporting sites in SWEDEHEART registry. "Type 2" MI was almost nonexistent in some sites (0.2%) and as...

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  • QRISK2 validation by ethnic group
    Julia Hippisley-Cox

    Tillin et al recently reported a cohort study[1] comparing the performance of QRISK2 and Framingham in the Southall and Brent cohort in London. We have a number of comments on the study and the interpretation of results.

    1. Number of events : The main problem with the paper, is that numbers are very small and given the resulting wide confidence intervals the authors have overstated their findings. There is no...

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  • Re:Considerations on the poor discriminatory power of the FRANCE-2 risk score
    Bernard Iung

    We thank Diaz and colleagues for their positive comments on the methodology used to develop the France-2 TAVI score. We also share their opinion that its discrimination limits the accurate identification of patients who are likely to die shortly after TAVI. This should, however, be balanced by the good calibration. We agree that "the creation of an efficient and reliable predictive model for TAVI seems to be of the bigg...

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  • The possible impact of lack of ethnic and geographical diversity on the association of MTHFR mutations, homocysteine levels and heart disease outcomes
    Naveen L. Pereira

    Methylenetetrahydrofolate reductase (MTHFR) plays an important role in conversion of homocysteine to methionine by catalyzing the production of 5-methyl tetrahydrofolate hence effectively decreasing plasma homocysteine levels. The MTHFR 677C>T nonsynonymous single nucleotide polymorphism (SNP) leads to a substitution of Valine for Alanine and results in the formation of a thermolabile variant of the enzyme with decr...

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