To the Editor: We have some concerns about the design of the surveillance study of sudden death after myocardial infarction (MI) by Dr Adabag and colleagues.1 First, the Mayo Clinic provides half of the primary care and nearly all specialty care for the community.2 A high proportion of the working population was employed in the health care industry. In addition to race and ethnicity, local diagnosis and treatment characteristics and the degree of awareness of disease may influence the outcome and prognosis of MI. These characteristics of this study population were not representative of a general population and therefore may not be valid for accurate comparisons to be made across geographic regions.
Zhao Z, Guan H, Shang L. Surveillance of Sudden Death After Myocardial Infarction. JAMA. 2009;301(11):1123-1124. doi:10.1001/jama.2009.284