Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
Copyright 1999 American Medical Association.
All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.1999
In Reply: We appreciate Dr
Cheng's observation on the possibility that cardiac rupture may have
been in part responsible for the differences in 6-month prognosis
between men and women found in the RESCATE (Resources Used in Acute
Coronary Syndrome and Delays in Treatment) study. Although our study
originally was not designed with the purpose of addressing such a
possibility, it showed that women died later over the 6 months after
onset of MI symptoms: median time to death was 4 days in men and 5.5
days in women (P< .01) in fatal cases. Thus, cardiac rupture
probably does not represent a major reason for women's excess risk of
death, since cardiac rupture generally occurs early after onset of
symptoms. To assess whether fatal cases were definitely due to cardiac
rupture, routine autopsy would be necessary. This was far beyond the
scope of our study.
Marrugat J. Cardiac Rupture After Myocardial Infarction—Reply. JAMA. 1999;281(8):703. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-8-jbk0224