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Discharge rates for suspected acute coronary syndromes
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     EDITOR—Mariotto assumes that "new fashioned" elderly people might be more able to recognise their symptoms and demand their rights. Although the greatest percentage change in population rates in each diagnostic subgroup was in elderly people, the major increase in absolute numbers of admissions occurred in those under the age of 75. From 1990 to 2000 the median age of patients admitted to hospital with a possible acute coronary syndrome decreased (from 61 to 59 years in men and from 68 to 65 years in women), as did the median age of patients admitted with chest pain (from 52 to 51 years in men and from 56 to 55 years in women).

    Sharieff thinks that the rise in emergency admissions might reflect "queue jumping" (presumably for coronary revascularisation). This seems unlikely over a period when the waiting time for revascularisation fell markedly in Scotland.

    Niamh Murphy, research fellow

    Department of Cardiology, Western Infirmary, Glasgow G12 8QQ

    John McMurray, professor

    j.mcmurray@bio.gla.ac.uk Department of Cardiology, Western Infirmary, Glasgow G12 8QQ

    Kate MacIntyre, specialist registrar

    Department of Public Health, University of Glasgow, Glasgow G12 8RZ