Does reperfusion induce myocardial necrosis?

1459 daily during at least 6 months in cases of recurrent pericarditis and during 3 months in cases of first episodes of pericarditis. Our results were recently reported,4 and they confirm the findings of Guindo et all and Rodriguez de la Serna et al.2 Eleven patients with recurrent pericarditis were included in the study. Previous treatments (nonsteroidal anti-inflammatory drugs in 10 patients and corticosteroids in one patient) had been unable to prevent a total number of 32 episodes of pericarditis and had induced two cases of severe erosive gastritis and one of corticode-pendence. After colchicine was started, no new recurrences and no side effects occurred during a mean follow-up of 10 months (range, 3-24 months). In cases of a first episode of pericarditis (19 patients), the ability to treat the acute phase was good when certain etiologies such as postpericardiotomy syndrome, viral pericarditis, and idiopathic pericarditis were concerned. Diarrhea occurred in one patient on the first day, and colchicine was stopped. When a specific treatment was required (e.g., for tuberculosis or pancreatitis), efficacy of colchicine became evident only after initiation of the specific treatment. In these 19 cases, ability to prevent recurrences was less evident because two recurrences occurred during a mean follow up of 5 months (range, 1-12 months). In the first case, the patient had stopped colchicine after 8 days without medical advice and had experienced a recurrence at 6 months. In the second case, the recurrence happened at 3 weeks, after a transitory improvement of clinical and biological signs during one week. We agree with Dr. Guindo that a further large, double-blind clinical trial is warranted that compares colchicine to a nonsteroi-dal anti-inflammatory drug like aspirin. Yet we think that this trial should be performed not only in cases of recurrent pericarditis but also in cases of a first episode of acute pericarditis. Reply It was with great interest that we read the letter of Millaire and Ducloux, and it is greatly encouraging for us to know that our resultsl2 have been confirmed by other authors. Furthermore, the results in this study turned out as "dramatic" as our own, as there were no new recurrences in any of the 11 patients with recurrent pericarditis when treated with colchicine.3 However, we cannot expect colchicine to be effective in all patients. Since our paper was prepared2 we have included five new patients and recurrence has just appeared in one …