Cardiovascular hospitalization as a surrogate endpoint for mortality in studies of XXXX : report from the Stockholm Cohort Study of @entity955 .

@entity1 @entity204 @entity955
AIMS: Cardiovascular (CV)-related hospitalization has been used as a surrogate endpoint for mortality in recent treatment studies on @entity955 ( @entity955 ), but our understanding of the relationship between CV-related hospitalization and @entity204 is incomplete. We aimed to investigate whether CV-related hospitalization is an independent risk factor and suitable as a surrogate endpoint for @entity204 in clinical studies of @entity1 with @entity955 . METHOD AND RESULTS: All 2912 @entity1 with a diagnosis of @entity955 in 2002 at one of Sweden's largest hospitals were studied for 6.5 years using information about medication from the local medical records. In a sub-study of the last 2.5 years of the study period, we used detailed information about medication from the new National Prescription Register. Information about diagnoses, hospitalizations, and deaths was obtained from national registries. @entity1 who were re-admitted to hospital with a CV diagnosis within the first 3 months had higher mortality than those who were not (15.6 vs. 9.3 deaths per 100 @entity1 -years at risk, P < 0.0001). Those who spent >2% of their time-at-risk in hospital with a CV diagnosis had higher mortality than those who had spent less time in hospital (36.0 vs. 8.2 deaths per 100 @entity1 years, P < 0.0001). After adjustment for co-factors, mortality was still higher for @entity1 who had been re-hospitalized for CV disease within 3 months than for those who had not [hazard ratio (HR) = 1.36; 95% confidence interval (CI) = 1.18-1.57]. When analyses were performed on @entity1 who had survived for 3 years since inclusion, and with the use of detailed information about the exposure to medication, the association between CV-related hospitalization and @entity204 was highly significant (HR 2.69, CI 1.96-3.68). These results were virtually unchanged after propensity score matching, which was done in order to adjust further for residual unidentified confounding. CONCLUSION: CV-related hospitalization is a marker for @entity1 who are at increased risk of @entity204 , and may be used as a valid surrogate endpoint in studies of @entity955 .
