[Acronyms must always be defined when used for the first time: AMADEUS].

I greatly enjoyed reading the epidemiological article on coronary artery disease in Spain by Marrugat et al,1 but I was disappointed to observe that, although the authors explained some of the acronyms of the studies mentioned in the article, like IBERICA, REGICOR, and MONICA, they did not define PANES and PRIAMHO. I am not sure why the criteria were applied so unevenly. With the aim of keeping offended journal readers2 from wasting their time trying to decipher these two acronyms, I would like to help them out. PANES means Prevalencia de ANgina en España (Prevalence of Angina in Spain), and PRIAMHO means Proyecto de Registro de Infarto Agudo de Miocardio HOspitalario (In-Hospital Acute Myocardial Infarction Registry Project).3 In accordance with the guidelines established by the International Committee of Medical Journal Editors,4 manuscripts submitted to biomedical journals must always define acronyms the first time that they are mentioned in the article. Unfortunately, authors are rarely held to this requirement.5 In the absence of the definition of an acronym, uninformed readers are forced to make a series of unnecessary assumptions. Acronymania is contagious and particularly affects cardiologists. It thus is not surprising that doctors are discouraged from reading specialist journals, particularly cardiology journals, many of which are full of undefined acronyms.6-14 For that reason I must again insist that acronyms must always be defined when used for the first time (AMADEUS). As must already be evident, I recognize that am a great admirer of Wolfgang Amadeus Mozart, whose musical composition is perfect and play of words, invariably explicit.16