O’Fee K, Deych E, Ciani O, et al. - According to findings of this meta-analysis, treatments that decrease nonfatal myocardial infarction (MI) cannot be presumed to reduce all-cause or cardiovascular (CV) mortality.

• This is a meta-analysis of 144 randomized clinical trials with data from 1,211,897 patients to assess if nonfatal MI could be a surrogate for all-cause or CV mortality in patients with or at risk for coronary artery disease.

• Nonfatal MI failed to meet the threshold for surrogacy for all-cause or CV mortality.

• Nonfatal MI was not a surrogate for all-cause mortality both in primary, secondary, mixed primary and secondary prevention, or revascularization trials and in trials enrolling patients before 2000, between 2000 and 2009, and from 2010 and after.

• In addition, in randomized clinical trials with 2.0 to 3.9, 4.0 to 5.9, or 6.0 or more years of follow-up, nonfatal MI was not a surrogate for all-cause mortality.