1. Coronary Artery Disease Mike Dorsch, Pharm.D.,M.S., BCPS

2. Chronic Disease Symptoms Acute Disease

3. CAD IHD ACS

15. HOPE trial 9,297 high-risk patients, > 55 years old, who had evidence of vascular disease or diabetes plus one other cardiovascular risk factor P<0.001 HOPE Investigators. NEJM 2000;342:145-53.

16. HOPE trial MI/Stroke/ CV Death CV Death MI Stroke Total Mortality 22% Risk Reduction p<0.001 25% Risk Reduction p<0.001 20% Risk Reduction p=<0.001 31% Risk Reduction p=<0.001 16% Risk Reduction p=0.006 Non CV Death 0% Risk Reduction p=0.78 HOPE Investigators. NEJM 2000;342:145-53.

18. Scandinavian Simvastatin Survival Study (4S) Years since randomization % Surviving 30% risk reduction p = 0.0003 The Lancet, Vol 344, November 19, 1994 4,444 patients with CAD

19. Scandinavian Simvastatin Survival Study (4S) 11.5% 8.2%

23. Antithrombotic Trialists ’ Collaboration Antithrombotic Trialists ’ Collaboration. BMJ 2002; 324: 71–86. *Vascular events = myocardial infarction, stroke or vascular death Control better Antiplatelet better Category % Odds Reduction Acute myocardial infarction Acute stroke Prior myocardial infarction Prior stroke/transient ischemic attack Other high risk Coronary artery disease (e.g. unstable angina, heart failure) Peripheral arterial disease (e.g. intermittent claudication) High risk of embolism (e.g. atrial fibrillation) Other (e.g. diabetes mellitus) All trials 1.0 0.5 0.0 1.5 2.0

28. Questions