Letter by Čulić Regarding Article, 'Physical Activity and Anger or Emotional Upset as Triggers of Acute Myocardial Infarction: The INTERHEART Study'

A recent analysis of data from the INTERHEART study1 confirmed that physical exertion and anger or emotional upset can trigger acute myocardial infarction (AMI) and that those triggers have an additive effect when they come together. At the same time, the results confute some previous observations on effect modification by individual characteristics or cardiovascular prevention medication.1 However, 2 issues seem to be worth noting. In the INTERHEART study, physical exertion was reported by 13.6% of participants during the case period.1 The estimated population attributable risk (ie, number of AMIs that could have been avoided if there has been no …