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Can Preventive Therapy Alter the Initial Presentation of Coronary Heart Disease?

Sidney C. Smith Jr, MD
[+] Article, Author, and Disclosure Information

From The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7075.

Potential Financial Conflicts of Interest: Consultancies: Pfizer Inc.; Honoraria: Merck, Bristol-Myers Squibb; Other: Data Safety Monitoring Board, AstraZeneca Research Clinical Trial.

Requests for Single Reprints: Sidney C. Smith Jr., MD, Center for Cardiovascular Science and Medicine, The University of North Carolina at Chapel Hill, CB #7075, 6th Floor, Burnett-Womack Building, 99 Manning Drive, Chapel Hill, NC 27599-7075.

Ann Intern Med. 2006;144(4):296-297. doi:10.7326/0003-4819-144-4-200602210-00012
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During the past 2 decades, a large body of evidence has accumulated about the effects of medical therapies given to reduce the risk for events associated with coronary heart disease (CHD). These studies and trials have usually focused on hard end points, such as total mortality rate, fatal and nonfatal myocardial infarction, and sudden death. Together, these interventions reduce the risk for a CHD event, especially when used in patients with known CHD (secondary prevention) and in high-risk patients with no history of CHD (primary prevention). In contrast, we know little about how these primary preventive therapies affect the way in which CHD initially presents (as the acute coronary syndrome or as stable angina pectoris).

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