This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Cardiovascular System  • Cardiovascular Disease/ Myocardial Infarction  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Drs Abumrad and Barbul note that prestudy and 6-month plasma arginine levels were similar in the placebo and active therapy groups. Although poor adherence is one possible explanation, pill counts at 1 month, 3 months, and 6 months indicate otherwise. We suggested that in this cohort with normal baseline arginine levels, up-regulation of enzymes responsible for arginine catabolism, as described by Morris¹ and Castillo et al,² is a more likely mechanism. The product we used was L-arginine hydrochloride, produced with a good manufacturing practice label.

We disagree with the characterization of the mortality rates in our study. In planning the study, we estimated a 10% mortality risk over 6 months in patients aged 60 years and older based on review of the literature.^3-4 The mortality in our study was lower than anticipated: 7.8% over 6 months in those patients aged 60 years and older and 3.9% for . . . [Full Text of this Article]

Steven P. Schulman, MD
sschulma@jhmi.edu

Gary Gerstenblith, MD
Division of Cardiology
Johns Hopkins University School of Medicine
Baltimore, Md

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Arginine Therapy for Acute Myocardial Infarction
Naji N. Abumrad and Adrian Barbul
JAMA. 2006;295(18):2138-2139.
EXTRACT | FULL TEXT  

L-Arginine Therapy in Acute Myocardial Infarction: The Vascular Interaction With Age in Myocardial Infarction (VINTAGE MI) Randomized Clinical Trial
Steven P. Schulman, Lewis C. Becker, David A. Kass, Hunter C. Champion, Michael L. Terrin, Sandra Forman, Kavita V. Ernst, Mark D. Kelemen, Susan N. Townsend, Anne Capriotti, Joshua M. Hare, and Gary Gerstenblith
JAMA. 2006;295(1):58-64.
ABSTRACT | FULL TEXT