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doesn’t have underlying significant cardiac risk factors and cardiac disease. I just have

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no idea what happens when you give this to someone who actually has coronary disease,

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who has had diabetes for a longer time and actually has these underlying risk factors.

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They tend to predispose someone to actually having myocardial infarction. If you don’t

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have a coronary artery disease, unless you have actually a prothrombotic effect, you don’t

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usually cause myocardial infarctions. You have to have an underlying substrate and that

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substrate takes time; so yes.

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used quite effectively in atrial fibrillation. I don’t think we would use them in a patient’s

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post myocardial infarction or with severe coronary disease, because, well we will talk

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about that. I think that is a reasonable example. There are multiple examples of drugs

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where we modify how we give them and who we give them to based upon the patient

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substrate and what their risk factors are at that time.

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about the risk of Torsade and sudden cardiac death with those agents.

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DR. TEERLINK: Well, in the CAS trial, where you--

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I am actually feeling quite comfortable giving this drug to a patient who

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insight into the cardiovascular risk of this agent in the patient population that was

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studied. I am actually, you know, so that I do believe we have some idea around that.

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The problem is, there actually is a whole series of drugs. We could go on forever talking

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about them. That actually depends upon the substrate of the patient population.

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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

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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

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