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September 29, 1978

Coronary Drug Project

JAMA. 1978;240(14):1483-1484. doi:10.1001/jama.1978.03290140025012

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To the Editor.—  In a recent letter (239:2655, 1978), Caceres and Enslein pointed out that the incidence of significant worsening of Q/QS patterns—as determined by comparison of the routine annual ECGs with the baseline ECG—at any time during the follow-up in the Coronary Drug Project (CDP) was 19.9% for the clofibrate-treated patients and 17.4% for the placebo-treated patients (line B of their Table). This represents a 14% higher incidence in the clofibrate group, though it is not statistically significant (P=.08). Also, from line C of their Table, the incidence of clinically diagnosed myocardial infarction (MI) was 14.7% for clofibrate and 15.3% for placebo—a 4% lower incidence in the clofibrate group. The substantial number of patients with Q/QS worsening without clinically diagnosed MI (as seen by comparing lines B and C of the Table) may be attributed to "silent infarcts," possible intraventricular defects causing widening of the QRS complex, biological