The American Journal of Medicine
Volume 122, Issue 8 , Pages 754-761 , August 2009

Raloxifene and Risk for Stroke Based on the Framingham Stroke Risk Score

  • Elizabeth Barrett-Connor, MD

      Affiliations

    • Departments of Family and Preventive Medicine, University of California, San Diego, La Jolla, Calif
    • Corresponding Author InformationRequests for reprints should be addressed to Elizabeth Barrett-Connor, MD, Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive 0607, La Jolla, CA 92093-0607
    • ,
  • David A. Cox, PhD

      Affiliations

    • Lilly Research Laboratories, Indianapolis, Ind
    • ,
  • Jingli Song, PhD

      Affiliations

    • Lilly Research Laboratories, Indianapolis, Ind
    • ,
  • Bruce Mitlak, MD

      Affiliations

    • Lilly Research Laboratories, Indianapolis, Ind
    • ,
  • Lori Mosca, MD, PhD

      Affiliations

    • Preventive Cardiology, Columbia University Medical Center, New York, NY
    • ,
  • Deborah Grady, MD

      Affiliations

    • University of California, San Francisco and the San Francisco VA Medical Center, Calif

References 

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  2. Cummings S, Eckert S, Krueger K, et al. The effect of raloxifene on risk of breast cancer in postmenopausal women. JAMA. 1999;281:2189–2197
  3. Barrett-Connor E, Mosca L, Collins P, et al. Raloxifene Use for The Heart (RUTH) Trial Investigators Effects of raloxifene on cardiovascular events and breast cancer in postmenopausal women. N Engl J Med. 2006;355:125–137
  4. Grady D, Cauley JA, Geiger MJ, et al. Raloxifene Use for The Heart Trial Investigators Reduced incidence of invasive breast cancer with raloxifene among women at increased coronary risk. J Natl Cancer Inst. 2008;100:854–861
  5. Barrett-Connor E, Grady D, Sashegyi A, et al. Raloxifene and cardiovascular events in osteoporotic postmenopausal women: four-year results from the MORE (Multiple Outcomes of Raloxifene Evaluation) randomized trial. JAMA. 2002;287:847–857
  6. Mosca L, Grady D, Barrett-Connor E, et al. Effect of raloxifene on stroke and venous thromboembolism: a randomized controlled trial in postmenopausal women with or at increased risk of coronary heart disease. Stroke. 2009;40:147–155
  7. Petty GW, Brown RD, Whisnant JP, et al. Survival and recurrence after first cerebral infarction: a population-based study in Rochester, Minnesota, 1975 through 1989. Neurology. 1998;50:208–216
  8. Sacco RL, Shi T, Zamanillo MC, Kargman DE. Predictors of mortality and recurrence after hospitalized cerebral infarction in an urban community: the Northern Manhattan Stroke Study. Neurology. 1994;44:626–634
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  10. Wolf PA, D'Agostino RB, Belanger AJ, Kannel WB. Probability of stroke: a risk profile from the Framingham Study. Stroke. 1991;22:312–318
  11. D'Agostino RB, Wolf PA, Belanger AJ, Kannel WB. Stroke risk profile: adjustment for antihypertensive medication (The Framingham Study). Stroke. 1994;25:40–43
  12. Goldstein LB, Adams R, Alberts MJ, et al. Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: the American Academy of Neurology affirms the value of this guideline. Stroke. 2006;37:1583–1633
  13. Cappuccio FP, Oakeshott P, Strazzullo P, Kerry SM. Application of Framingham risk estimates to ethnic minorities in United Kingdom and implications for primary prevention of heart disease in general practice: cross sectional population based study. BMJ. 2002;325(7375):1271–1276
  14. Vokó Z, Hollander M, Koudstaal PJ, et al. How do American stroke risk functions perform in a Western European population?. Neuroepidemiology. 2004;23:247–253
  15. Cauley JA, Norton L, Lippman ME, et al. Continued breast cancer risk reduction in postmenopausal women treated with raloxifene: 4-year results from the MORE trial (Multiple outcomes of raloxifene evaluation). Breast Cancer Res Treat. 2001;65:125–134
  16. Mosca L, Barrett-Connor E, Wenger N, et al. Design and methods of the Raloxifene Use For the Heart (RUTH) Study. Am J Cardiol. 2001;88:392–395
  17. Rockhill B, Byrne C, Rosner B, et al. Breast cancer risk prediction with a log-incidence model: evaluation of accuracy. J Clin Epidemiol. 2003;56:856–861
  18. Eichler K, Puhan MA, Steurer J, Bachmann LM. Prediction of first coronary events with the Framingham score: a systematic review. Am Heart J. 2007;153:722–731731.e1-8
  19. O'Regan C, Wu P, Arora P, et al. Statin therapy in stroke prevention: a meta-analysis involving 121,000 patients. Am J Med. 2008;121:24–33

 Funding: Studies funded by Lilly Research Laboratories.

 Conflict of Interest: Elizabeth Barrett-Connor and Deborah Grady were paid external investigators for the Raloxifene MORE and RUTH studies by Lilly Research Laboratories. Lori Mosca was a paid external investigator for the Raloxifene RUTH study by Lilly Research Laboratories. David A. Cox, Jingli Song, and Bruce Mitlak are employees of Lilly Research Laboratories and have financial interest in the company.

 Authorship: All authors had access to the data and a role in writing the manuscript.

PII: S0002-9343(09)00333-7

doi: 10.1016/j.amjmed.2009.01.033

The American Journal of Medicine
Volume 122, Issue 8 , Pages 754-761 , August 2009

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