Agewall et al 1 compared the risk factors for myocardial infarction (MI) with normal coronary arteries (MINCA) versus that for MI with coronary artery stenosis. The authors do not report the thyroid function tests.The association between hyperthyroidism (overt or subclinical) and acute ischemic heart disease has been the subject of considerable debate. [2][3][4][5][6] The proposed mechanisms responsible for coronary events in hyperthyroidism include a hypercoagulable and hypofibrinolytic state as well as hyperthyroidismassociated coronary vasospasm and increased myocardial oxygen demand. 3,7 In the literature, most patients with MI associated with hyperthyroidism have normal coronary arteries (documented by both angiographic and postmortem studies). [2][3][4][5][6] Although these mechanisms explain MI in hyperthyroid patients, some authors claim that this concurrence is coincidental. 5,6 They emphasize that both coronary events and hyperthyroidism are common and most hyperthyroid patients do not experience such events. Actually, most of the literaturerelated to hyperthyroidism-associated MINCA-consists of case reports. [2][3][4][5][6] Further prospective studies are needed to resolve the link, if any, between hyperthyroidism and MINCA.We wonder whether thyroid status was available in Agewall et al's 1 study. This information could be useful in clarifying the relationships discussed above.