Coronary event rate

Kuulasmaa, K., Tynstall-Pedoe, H., Dobson, A., Fortmann, S., Sans, S., Tolonen, H., Evans, A., Ferrario, M., Tuomilehto, J. 2000. Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA project populations. Lancet. 355, 675-687. 

Of particular interest are the results of the West of Scotland Coronary Prevention Study in which the relationship between the observed incidence of coronary heart disease events was compared with that predicted from an equation that incorporates cholesterol levels, smoking history, diabetes, blood pressure, and other risk factors that were known at the time (38). These results, shown in Figure 17.5, indicate that the predicted and observed event rates in patients who received placebo were similar. On the other hand, coronary event rates in pravastatin-treated patients were consistently lower than were... 

PAPWORTH 255 postmenopausal women with coronary heart disease Transdermal 17 S-estradiol 80 mcg/day alone for women with hysterectomy transdermal 17 S-estradiol, 80 mcg/day plus cyclic transdermal norethisterone 120 mcg/day for 14 days or placebo No reduction in the incidence of acute coronary events (coronary disease death, myocardial infarction, unstable angina) among women in the hormone therapy group During the first 2 years of follow-up, the hormone-therapy group had a higher acute coronary event rate than the control group. 

Timstall-Pedoe, H., Kuulasmaa, K., Mahonen, M., Tolonen, H., Ruokokoski, E., and Tkmouyel, P. (1999). Contribution of trends in survival and coronary-event rates to changes in coronary heart disease mortality 10-year results from 37 WHO MONICA Project populations. Lancet, 353(9164), 1547-1557. 

Approximately 2 percent of patients have to discontinue taking these drugs due to side effects. The most common include the gastrointestinal tract (abdominal pain, diarrhea, constipation, and flatulence). Occasionally, patients may also develop muscle pain. Nevertheless, in summary, HMG-CoA inhibitors are the lipid-lowering drugs of first choice for treatment of most patients at risk for CAD. A long-term decrease in the rate of mortality or major coronary events has been documented with pravastatin, simvastatin, and lovastatin. 

Tunstall-Pedoe H, Kuulasmaa K, Amouyel P et al. (1994). Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates and case-fatality rates in 38 populations from 21 countries in four continents. Circulation 90 583-612 Wald NJ, Law MR (2003). A strategy to reduce cardiovascular disease by more than 80%. British Medical Journal 326 1419 White H, Boden-Albala B, Wang C et al. (2005). Ischemic stroke subtype incidence among whites, blacks and Hispanics the Northern Manhattan Study. Circulation 111 1327-1331 Wityk RJ, Pessin MS, Kaplan RF et al. (1994). Serial assessment of acute stroke using the NIH Stroke Scale. Stroke 25 362-365. 

Fig. 17.1. Kaplan-Meier event rates for any stroke, any myocardial infarction (Ml) or death from coronary heart disease (CHD), and any stroke, Ml or vascular death in a cohort of 290 patients with transient ischemic attack (Clark et ai. 2003),...

GUSTO-1 and EPILOG, two different antithrombotic trials, GUSTO-1 and EPILOG, the first in acute myocardial infarction and the second during coronary stenting, compared the event rates in patients taking aspirin, an ACE inhibitor, or both (110). In each of these trials, events... 

Cesaroni G, ForastiereF, Agabiti N, et al. Effect of the Italian smoking ban on population rates of acute coronary events. Circulation 2008 117(9) 1183—8. 

For each trial, data were abstracted on the number allocated to each treatment and the number of coronary events, stroke events, cancer events, and deaths from any cause by treatment allocation. The expected number of events assuming treatment had no effect and the observed minus expected (o-e) statistics and their variances (v) were calculated for each trial and summed to produce, respectively, a grand total observed minus expected (G) and its variance (V) (Early Breast Cancer Trialists Collaborative Group 1990). The one-step estimate of the log of the event rate ratio is G/V. The test statistic (x n-i) for heterogeneity between n trials is S-(G /V), where S is the sum over all the trials of (o-e) /v (Cochran 1954). All analyses were carried out using SAS (Version 9.1). 

In a matched cohort study, in which 200 patients who received high-dose aprotinin were compared with 200 age- and sex-matched patients who received tranexamic acid during primary isolated coronary surgery, there were no significant differences in fractional change in creatinine clearance or any other assessments of postoperative renal function between the two groups [202 ]. Adverse events rates were also similar for early mortality (3.5% versus 4.5%), stroke... 

Fig. 6. National Cooperative Pooling Project serum cholesterol at entry and 10 year age-adjusted rates per 1,000 men for first major coronary event and sudden death (upper graph), any coronary death and death from all causes (lower graph) first major coronary event includes non-fatal myocardial infarction, fatal myocardial infarction and sudden death due to CHD U.S. white males age 30-59 at entry all rates age-adjusted by 10-year age groups to the U.S. white male population, 1960 (4).

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