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July 3, 2002

Raloxifene and Risk of Cardiovascular Events

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;288(1):42-43. doi:10.1001/jama.288.1.42

To the Editor: Dr Barrett-Connor and colleagues1 concluded that 4 years of postmenopausal raloxifene therapy significantly reduces the risk of cardiovascular events in women who are at increased risk. Several aspects of the authors' classification scheme, however, limit the validity of their findings.

The criteria used to create a subset of women "with increased cardiovascular risk"1 seem arbitrary and prone to incorrect risk stratification. I believe that it is inappropriate, for instance, that women with diabetes mellitus received as much as 75% of the points as did women with prior myocardial infarction, especially given the nonstandard definitions used to classify certain risk factors, such as diabetes, used in this study. The rationale for the point system is not justified either in this study or in the referenced article,2 which uses a slightly different system.

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