Increased QT dispersion with the D-allele of the ACE polymorphism

have on the health of the population. Therefore, practice guidelines are necessary to influence decision making, but should not be used to enforce medical decisions. Sufficient flexibility and divergence from tailor-made diagnostic and therapeutic strategies should be allowed. Guidelines should be a reference standard against which individual decision making should be assessed, and if in the view of a responsible physician a particular strategy is justifiable, then it should be implemented. Hence the take home message is: coronary revascularization needs to be done when it needs to be done. H. MEHTA B. MEIER Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland