Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: The selection of optimal therapy for patients with acute coronary syndrome remains a major issue for this common medical problem. The authors of these 2 letters highlight that the mechanism of the effect of these variants' interaction with β-adrenergic antagonists remains an unresolved and interesting question. Many plausible hypotheses can be proposed to explain the observations. In regard to the comments of Drs Snyder and Johnson, our data do not demonstrate that β-adrenergic antagonists “increase mortality” in any subgroup. The results may reflect a lack of benefit of β-blockade, rather than an actual harm due to therapy. The mechanism of effect they propose is intriguing and deserves further study.
Lanfear DE, Spertus JA, McLeod HL. β. JAMA. 2006;295(7):756-758. doi:10.1001/jama.295.7.757-b