this is a very interesting study; but i do believe that at least we need to relay on one clinical trial to confirm this relationship with strict eligibility criteria to eliminate cardiovascular risks. however, this article is very helpful for me especially for ITP patients.
Best Regards
Article Myocardial Infarction Associated with Intravenous Immune Globulin
Establishing causal relationship needs a highly controled clinical tria (RCT). in addition, all the rival hypothesis (confounding variables) must be eliminated. Therefore, it is highlikly to say there is strong relationship rather than causal one. Regards
Causality can only truly be investigated as part of a mediation study that has randomization at two time-points, the first being up-front (as per usual protocol in an RCT), and then again at the the point in which an intermediate outcome variable is measured. The intent is to demonstrate that the treatment caused the intermediate outcome and then this outcome led to the final outcome. Without such a detailed approach, we can only assume that the treatment caused the outcome, which may or may not be the true case.
I am attaching a paper that discusses this approach, and uses a similar example for context. The bibliography is extensive and can provide further guidance.
I hope this helps
Ariel
Article Using mediation analysis to identify causal mechanisms in di...
As a clinician I will say "yes" it is way too early to claim the causal relationship. If there are a few similar case reports then we may consider the possibility.
Difficult to use the term 'causal' even in this patient who had otherwise many potential reasons to have an MI. To the very best we could wonder whether it was a precipitating factor but the term causal is inappropriate.
