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Prinzmetal Angina and Cyproheptadine
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 Unpublished letters cannot be returned.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.
TO THE EDITOR:
Schecter and colleagues [1] reported that a subset of patients with Prinzmetal angina who were refractory to nitrites and calcium channel blockers responded to the antiserotonergic agent cyproheptadine. Little information is available on the mechanisms of action involved or on why some other antiserotonergic agents were inactive in this disorder.
In an earlier study [2], we found that cyproheptadine substantially inhibited platelet aggregation in vivo, ex vivo, and in vitro. It inhibited both serotonin and adenosine diphosphate-induced aggregation. The agent also has antihistamine activity. Inhibition of platelet aggregation may break the vicious cycle in which serotonin is released from aggregating platelets on arteriosclerotic plaques causing more platelet aggregation and more serotonin release. These relatively high concentrations of serotonin then interact with arteriosclerosis-altered vascular walls, thus causing vasospasm.
Julian L. Ambrus
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.
- Copyright ©2004 by the American College of Physicians
