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May 21, 1982

Lidocaine Prophylaxis and Myocardial Infarction

Author Affiliations

The Mount Sinai Medical Center New York

JAMA. 1982;247(19):2662. doi:10.1001/jama.1982.03320440014017

To the Editor.—  Ralph I. Horwitz, MD, and Alvan B. Feinstein, MD, in a recent article (1981;246:2455) suggested that careful attention to patient eligibility criteria might improve case-control studies. This seems to be a reasonable suggestion, and we are optimistic that its value will be confirmed. However, we fear that the authors' enthusiasm for their "new strategy" may have caused them to overlook other important principles of study design in the example they use (lidocaine hydrochloride prophylaxis in acute myocardial infarction [MI]). This is surprising, since the principles have been emphasized by these same authors in critiques of other investigators' work.The importance of carefully defining diagnostic criteria, including history, ECG, and enzyme values, was pointed out by Gifford and Feinstein in their analysis of articles dealing with anticoagulants for acute MI.1 Why, then, is the reader told only that the study included "patients... discharged with a diagnosis of