Chest pain--another adverse reaction to vancomycin.

The article by John Cappola et al (Chest 1989; 95:1309-15) states that randomized studies assessing the efficacy of coronary artery bypass surgery in acute myocardial infarction are not available. We wish to draw their attention to our article, “Urgent Surgical Reperfusion in Acute Evolving Myocardial Infarction; a Randomized Controlled Study” published in Circulation 1988; 79(3):I17178. This work was performed at the University of Ottawa Heart Institute, Ottawa Civic Hospital, comparing the standard medical management of acute evolving myocardial infarction and aortocoronary bypass graft surgery. Sixty-eight patients presenting within 4 h of the onset of chest pain were randomized into medical and surgical groups. Our conclusions were that urgent surgical reperfusion in acute evolving myocardial infarction was safe and effective and appeared to reduce early and late mortality. However, at three months post infarction there was no significant differences in the ejection fraction in the survivors between the two groups.