Association of hyperhomocysteinemia with coronary artery disease in southern Iran

Abstract

Dear Editor, In response to the criticisms regarding the article entitled; “association of hyperhomocysteinemia with coronary artery disease in Southern Iran”, published in Iran J Med Sci,1 we still believe the methodology used in this study was a case control design as the cases where chosen on the basis of outcome (coronary artery disease) and the controls were individuals without the disease or outcome. In this study the individual affected by coronary artery disease were compared with a control group of unaffected individuals. The history of both cases and controls were analyzed to identify the characteristic and risk associated with hyperhomocystenemia present in the cases. Regarding the relative risk terminology we agree with the critics that perhaps the “estimate or approximate relative risk” would have been a better terminology to use in this case control study rather than relative risk.We also agree with the critics that cohort study would have been a better option but the estimate relative risk derived from the case control studies often agree with those obtained from the cohort studies.