Mortality rates
Kiwi,the price of $260 per month is quite steep. I guess I just got lucky. My insurance co-pay was $20, which was further reduced to $9 with a saving card.
As you know, the mortality rates after MI reported in different studies could be quite different. No one will be sure about the true mortality rates in Reduce IT study until the study is stopped and unblinded. However, in my view, the following two CV outcome studies provide us a glimpse of background mortality rate that could be similar to the Reduce IT study. The 1st study GISSI-P(Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial, Lancet 1999; 354: 447–55) showed that the control group (2828 subjects followed for 3.5 years) had 3.0% per year all fatal event and 1.9% per year CV death. N-3 PUFA significantly reduced all fatal event to 2.4% per year and CV death to 1.4% per year, respectively (% values were calculated by dividing observed percentage of patient death reported in the study by 3.5 years). LDL and TG levels at baseline in that study was 139 and 162, respectively.
A more recent study (Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes; N Engl J Med 2015;372:2387-97) showed that the control group (simvastatin, 9067 subjects with 40026 patient years) had 1231 death from any cause (3.08% per year), 538 cardiovascular death (1.34% per year). LDL and TG levels at baseline were 94 and 138, respectively. Ezetimide did not reduce any mortality rates at all.
If the Reduce IT study has a similar or better efficacy in reducing mortality rates than the GISSI-P trial, Vascepa will be a game changer. It is not only for our investment return, but more importantly for us to live a healthier and more abundant life.
Abstract of GISSI-Prevenzione trial
Background There is conflicting evidence on the benefits of
foods rich in vitamin E (?-tocopherol), n-3 polyunsaturated
fatty acids (PUFA), and their pharmacological substitutes. We
investigated the effects of these substances as supplements
in patients who had myocardial infarction.
Methods From October, 1993, to September, 1995, 11 324
patients surviving recent (_3 months) myocardial infarction
were randomly assigned supplements of n-3 PUFA (1 g daily,
n=2836), vitamin E (300 mg daily, n=2830), both (n=2830),
or none (control, n=2828) for 3•5 years. The primary
combined efficacy endpoint was death, non-fatal myocardial
infarction, and stroke. Intention-to-treat analyses were done
according to a factorial design (two-way) and by treatment
group (four-way).
Findings Treatment with n-3 PUFA, but not vitamin E,
significantly lowered the risk of the primary endpoint (relative risk
decrease 10% [95% CI 1–18] by two-way analysis, 15%
[2–26] by four-way analysis). Benefit was attributable to a
decrease in the risk of death (14% [3–24] two-way, 20%
[6–33] four-way) and cardiovascular death (17% [3–29] two way,
30% [13–44] four-way). The effect of the combined
treatment was similar to that for n-3 PUFA for the primary
endpoint (14% [1–26]) and for fatal events (20% [5–33]).
Interpretation Dietary supplementation with n-3 PUFA led to
a clinically important and statistically significant benefit.
Vitamin E had no benefit. Its effects on fatal cardiovascular
events require further exploration.
Lancet 1999; 354: 447–55
