Dihydrotestosterone—a culprit in left ventricular hypertrophy

Abstract

and signs of heart failure, whereas the coexistence of medical comorbidities were not fully considered. The complexity and time constraints of Charlson comorbidity index might limit its use in AMI stratification. Besides, the Charlson index counts myocardial infarction as comorbid conditions [4]. The numberofmedical comorbidities for the early risk stratification of patients with AMI was objective, economical, simple to perform, and based entirely on information at admission, especially for primary care physicians. This informationmight be easy to obtain, and not time-consuming. Based on the number of medical comorbidities at admission, the risk of in-hospital mortality could be further evaluated. Those with more comorbidities were more likely to have higher in-hospital mortality, and merit intensive in-hospital managementandnursing care. For thosewithout comorbidity, relatively lessmedical andnursing services couldbeprovided,whichmight lead to reduced burden of medical expenses. It was hopeful that medical comorbidities at admission could be included in future risk scoring system or combined with other risk index for more precise early risk stratification of patients hospitalized with AMI. This study had limitations. First, it was not a randomized trial. Second, the effect of comorbidities at admission on in-hospital mortality were gaged by counting the number of comorbidities. A better method would be to construct an index that weighed medical comorbidities according to their impact on in-hospital mortality, which might be of more help in clinical practice. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology (Shewan and Coats 2010;144:1–2).