Author Affiliation: Division of Cardiology, University Hospital Split, Split, Croatia (email@example.com).
To the Editor: In their systematic review, Drs Dahabreh and Paulus confirmed that episodes of physical or sexual activity may be associated with acute coronary syndromes or sudden cardiac death.1 A valuable contribution of a systematic review is determination of different risks in subgroups. The meta-analysis1 found that the subgroup with greater habitual physical activity had a reduced risk of acute cardiac events after exposure to triggering activities.
Čulić V. Association Between Episodic Physical and Sexual Activity and Acute Cardiac Events. JAMA. 2011;306(3):265-266. doi:10.1001/jama.2011.983