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To the Editor:
—In reference to the article "Clinical Evaluation of Heparin in the Treatment of Angina Pectoris" by Binder and his associates in The Journal (151:967 [March 21] 1953), there are several points I wish to consider. This problem is of more than passing interest, since the role of heparin in fat transport is being intensively investigated.The persons studied were domiciliary patients residing at a Veterans Administration Center and nearly all of them had had angina pectoris for five years. This group would be resistant to therapy not only because of the long duration of angina with probably markedly calcific vessels, but particularly because the security of such patients in residence at a veterans' facility is threatened by any considerable improvement in symptoms. Under these circumstances both conscious and unconscious emotional factors operate to negate the effect of therapy, especially in instances in which a subjective response,
Engelberg H. HEPARIN AND ANGINA PECTORIS. JAMA. 1953;152(5):474. doi:10.1001/jama.1953.03690050098025
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