Overview of Results of Randomized Clinical Trials in Heart Disease: II. Unstable Angina, Heart Failure, Primary Prevention With Aspirin, and Risk Factor Modification

THIS is the second of a two-part article on the results of randomized trials of treatments designed to reduce mortality or major morbidity in heart disease. Our goal is to summarize the results of trials of common treatments on major outcomes in unstable angina, congestive heart failure, primary prevention with aspirin, and risk factor modification. This summary should provide useful background information against which clinicians must consider other information (eg, patient prognosis, risk of side effects, drug interactions, and specific clinical picture) in making decisions about individual patients. We do not deal in either article with trials of coronary artery bypass graft surgery for stable angina, trials of valve replacement, or congenital heart disease. The risk reductions are based on the odds ratio calculated by the Mantel-Haenszel method as applied to combining data from several trials. When event rates are low, the odds ratio and the relative risk are numerically