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Carbon Monoxide Poisoning, Myocardial Injury, and Mortality
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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To the Editor: Mr Henry and colleagues1 studied long-term mortality among a large group of patients with CO poisoning. There are several issues in their study that we believe need to be addressed.
The authors previously identified subsets of these patients with significant age and echocardiogram differences (global vs regional wall motion abnormality), suggesting that the former experienced CO-related "stunned myocardium," while the latter had "unmask[ed] underlying CAD."2 Did the mortality rates in these 2 groups differ at follow-up? The statistically significant mortality differences in the univariable analyses of previous diabetes, hypertension, and prior history of congestive heart failure or coronary artery disease as predictors in the present study would support such a difference. Was there any difference between patients with and without initial myocardial injury in their reported duration of CO exposure? Furthermore, while it is not clear if "time is muscle" applies to CO-induced myocardial injury, did door-to-chamber . . . [Full Text of this Article]
Alberto Perez, MD
aaperez@harthosp.org
Kelly Johnson-Arbor, MD;
Charles A. McKay, MD
Division of Medical Toxicology
Hartford Hospital
Hartford, Conn
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