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Bedford F. Boylston, MD
Lemoyne, Pa

JAMA. 1996;276(2):100.

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

To the Editor.

—The article by Dr Bennett-Guerrero and colleagues¹ gives the impression that triiodothyronine (T₃) is being considered for routine use in the community as an inotropic agent after coronary artery bypass surgery. My hospital's cost for T₃ is $900, and the cost for dopamine is $15. Dopamine will always be preferential on a routine basis on cost alone.

Animal data show that T₃ is most beneficial after severe global myocardial ischemia.^2-4 Yet the study by Bennett-Guerrero et al excluded all preoperative patients requiring intraaortic balloon pump or inotropic support. Essentially, the group of patients most likely to benefit were excluded from the trial.

The comparison of a hormone to an inotropic agent is the comparison of apples to oranges. The mechanism of action is different. No one is sure how T₃ works on myocardial cell function. I agree that dopamine is the . . . [Full Text PDF of this Article]

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