Exploring the Treatment-Risk Paradox in Coronary Disease

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Abstract
It is well documented that proved, efficacious therapies are often suboptimally applied in clinical practice.1 For example, almost half of eligible patients with coronary artery disease (CAD) do not receive statins, and older individuals, women, and patients with substantial comorbidities are less likely to be prescribed evidence-based therapies for their cardiovascular diseases than younger and/or healthier individuals.1-9 It has recently been suggested that there is a “treatment-risk paradox” in cardiovascular pharmacotherapy, such that clinicians preferentially initiate treatment in low-risk individuals and are less likely to prescribe new therapies in those patients at highest risk for poor outcomes from the underlying condition.8-13

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