We read with interest the article by Abu-Assi et al.1 on the impact of left coronary dominance on prognosis in the context of ST-segment elevation myocardial infarction and, in addition to wishing to congratulate the authors for the contribution it represents, as well as on their elegant statistical analysis, we consider it appropriate to put forward certain considerations.

Although the available data are limited, it is reasonable to think that the occlusion of a coronary artery could have a stronger impact in a patient with 2 major vessels (left dominance) than in a patient with 3. This is the point that the above-mentioned article makes in the conclusions, which can undoubtedly have a simple practical application.1,2 Nevertheless, it might be interesting to know whether the prognostic influence of the dominance pattern is maintained specifically in the group of patients with involvement of the anterior descending artery (anterior myocardial infarctions) and, if so, to examine whether its importance is greater or lesser than when the myocardial infarction affects the territory of the circumflex artery (the segments in question when dominance is discussed). In addition, it would also be interesting to know whether, after stratification for the severity of ventricular dysfunction, coronary dominance would still be a relevant prognostic factor to be considered from the clinical perspective.