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Sex-related Outcome Differences after Acute Myocardial Infarction
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IN RESPONSE:
Mensah and colleagues raise several interesting points about the mechanisms responsible for the higher morbidity and mortality rates in women after acute myocardial infarction. The Thrombolysis in Myocardial Infarction (TIMI II) database was explored to evaluate potential sex-related differences in left ventricular hypertrophy (Table 1).
Although we could not uncover any sex-related differences, several limitations do exist. First, TIMI II used strict entry criteria and excluded patients with uncontrolled hypertension [1]. Second, simplified R-wave criteria (Lyons criteria) were the only means available to assess the occurrence of left ventricular hypertrophy. Previous studies have shown that electrocardiographic criteria, although specific, lack sensitivity, particularly among women [2]. Other assessments of left ventricular hypertrophy such as echocardiography were not routinely done in TIMI II [3-5].
We appreciate the interest of Dr. Mensah and colleagues in our work and agree that left ventricular hypertrophy among women and men experiencing acute myocardial infarction is of concern and must be addressed in future studies.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
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