doesn’t have underlying significant cardiac risk factors and cardiac disease. I just have
no idea what happens when you give this to someone who actually has coronary disease,
who has had diabetes for a longer time and actually has these underlying risk factors.
They tend to predispose someone to actually having myocardial infarction. If you don’t
have a coronary artery disease, unless you have actually a prothrombotic effect, you don’t
usually cause myocardial infarctions. You have to have an underlying substrate and that
substrate takes time; so yes.
used quite effectively in atrial fibrillation. I don’t think we would use them in a patient’s
post myocardial infarction or with severe coronary disease, because, well we will talk
about that. I think that is a reasonable example. There are multiple examples of drugs
where we modify how we give them and who we give them to based upon the patient
substrate and what their risk factors are at that time.
about the risk of Torsade and sudden cardiac death with those agents.
DR. TEERLINK: Well, in the CAS trial, where you--
I am actually feeling quite comfortable giving this drug to a patient who
insight into the cardiovascular risk of this agent in the patient population that was
studied. I am actually, you know, so that I do believe we have some idea around that.
The problem is, there actually is a whole series of drugs. We could go on forever talking
about them. That actually depends upon the substrate of the patient population.
DR. KONSTAM: So first of all, I mean when you are talking about the
type 1C antiarrhythmics I think it’s an interesting example. I assume you are talking
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Two of them, for example, are the type 1C antiarrhythmics, which are
DR. KONSTAM: Okay. We have to distinguish between, and I think this
gets to Rebecca’s point as well. You have to distinguish between relative risk and