A Group of Cardiologists Hypothesized That a New ACE Inhibitor

question 1111

Multiple Choice

A group of cardiologists hypothesized that a new ACE inhibitor improves outcomes among patients with left ventricular dysfunction whether they have heart failure or not.  The cardiologists assessed the role of the new ACE inhibitor in patients who were at high risk for cardiovascular events but who did not have left ventricular dysfunction or heart failure.  A total of 8,560 high-risk patients (age ≥55) with evidence of vascular disease or diabetes plus one other cardiovascular risk factor but with no known history of heart failure were randomly assigned at a ratio of 1:1 to receive the new ACE inhibitor or placebo for a mean of 5 years.  The primary outcome was death from cardiovascular causes.  A total of 261 patients assigned to receive the new ACE inhibitor (6.1%) died from cardiovascular causes, compared to 346 patients assigned to receive placebo (8.1% percent) (relative risk = 0.75; p < 0.05) .  Which of the following conclusions can be drawn from these results?

• A)A 95% confidence interval for the relative risk reported by the study would exclude the null value
• B)The new ACE inhibitor reduced the rate of death from cardiovascular causes by 75%
• C)The rate of death from cardiovascular causes was 25% higher among patients assigned to placebo
• D)The treatment had no effect on the rate of death from cardiovascular causes

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