Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2016;69:350-1 - Vol. 69 Num.03 DOI: 10.1016/j.rec.2015.11.028

Sensationalist Headlines: Also in the Scientific Press? Response by Abu-Assi et al

Emad Abu-Assi a,, Sergio Raposeiras-Roubin a, José Ramón González-Juanatey a

a Servicio de Cardiología y Unidad Coronaria, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain

Refers to

Sensationalist Headlines: Also in the Scientific Press?
Armando Pérez de Prado, Carlos Cuellas Ramón, Rodrigo Estévez Loureiro, María López Benito, Felipe Fernández Vázquez
Rev Esp Cardiol. 2016;69:350
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Article

To the Editor,

Apparently, Pérez de Prado et al continue to appreciate our scientific contributions.1, 2 Concerning our latest article, they express their opinion—we would say with too visceral an attitude and taking no notice of the important methodological details of our study—that we make use of a sensationalist title.2

The original title of the article was “Medium- to Long-term Risk of Infarction, Stroke, or Cardiovascular Death Following Acute Coronary Syndrome. Incidence and Development of Predictive Tools”. The editors of Revista Española de Cardiología considered the present title to be more appropriate; we accepted.

Thus, we are surprised by the letter and its style, and would like to enlighten its authors about 2 basic methodological facts. When studies and procedures are highly prevalent in a population (as is the case with revascularization in our article, with a prevalence of ¿ 70%), they may not emerge as prognostic determinants during a phase of the study. On the other hand, our study was conducted in a heterogeneous population with different levels of risk for the composite event of reinfarction (quantitatively, it represented the major component of the composite event), stroke, or cardiovascular death. Under these conditions, our observation should not come as a surprise. For example, in the population of patients with myocardial infarction included in the multicenter TRIUMPH (Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients’ Health Status) registry, recruited in 24 hospitals in the United States, in-hospital percutaneous revascularization was even associated with a higher adjusted risk of rehospitalization for an acute coronary syndrome (hazard ratio = 1.85; 95% confidence interval, 1.28-2.69; P = .001) after 1 year of follow-up.3 Therefore, we consider it unfortunate that the authors, in their comment, failed to differentiate between effectiveness (impact resulting from an action carried out under the usual conditions) and efficacy (impact on health status of an action carried out under optimal conditions or under ideal conditions for its use and application) for a correct interpretation of our study. Finally, we should point out that the fact that a treatment does not completely resolve a problem is not synonymous with therapeutic nihilism.

CONFLICTS OF INTEREST

E. Abu-Assi is a member of the editorial team of Revista Española de Cardiología.

Corresponding author: eabuassi@gmail.com

Bibliography

1. Pérez de Prado A, Cuellas-Ramón C, Diego-Nieto A, Fernández-Vázquez F. Validation and applicability of a risk score: the more data, the better. Rev Esp Cardiol. 2010;63:1387-8.
2. Abu-Assi E, López-López A, González-Salvado V, Redondo-Diéguez A, Peña-Gil C, Bouzas-Cruz N, et al. El riesgo de eventos cardiovasculares tras un evento coronario agudo persiste elevado a pesar de la revascularización, especialmente durante el primer año. Rev Esp Cardiol. 2016;69:11-8.
3. Arnold SV, Smolderen KG, Kennedy KF, Li Y, Shore S, Stolker JM, et al. Risk factors for rehospitalization for acute coronary syndromes and unplanned revascularization following acute myocardial infarction. J Am Heart Assoc. 2015.

1885-5857/© 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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