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Discontinuation of hormone replacement therapy after myocardial infarction and short term risk of adverse cardiovascular events: nationwide cohort study

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e1802 (Published 27 March 2012) Cite this as: BMJ 2012;344:e1802

Re: Discontinuation of hormone replacement therapy after myocardial infarction and short term risk of adverse cardiovascular events: nationwide cohort study

First of all I must congratulate Ditte-Marie Bretler and co-authors for such an impeccable paper. They have taken care of all confounding factors, such as, age groups, mode and type of HRT, type of treatment of myocardial infarction, coexisting morbidities and treatment etc. Smoking and obesity could not be excluded or adjusted and authors have admitted them as limitations of the study.

Only suggestion I have is that extent of myocardial infarction (extent of coronary atherosclerosis) should also have been determined or whether it was a major heart attack or not at the entry point. But this also has partially been taken care of by excluding the deaths within 30 days of index myocardial infarction and adjusting for the type of treatment.

Competing interests: No competing interests

30 March 2012
Neeru Gupta
Scientist E
Indian Council of Medical Research
Ansari Nagar, New Delhi-110029
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