Mortality and Morbidity in Patients Receiving Encainide, Flecainide, or Placebo¶
Echt, D. S., Liebson, P. R., Mitchell, L. B., Peters, R. W., Obias-Manno, D., Barker, A. H., Arensberg, D., et al. (1991). Mortality and Morbidity in Patients Receiving Encainide, Flecainide, or Placebo: The Cardiac Arrhythmia Suppression Trial. New England Journal of Medicine, 781-788.
Cited by¶
1 citation across 1 artifact.
Primes¶
- Proxy–Target Fidelity
- And the substitution risk is realized in documented cases where a drug improved the surrogate (suppressed arrhythmias, raised HDL, lowered glucose) while increasing mortality — the proxy moved the intended way and the target moved the opposite way, the exact catastrophe of treating a stand-in as the thing.
Supported in partVerified against the work's full text
CAST shows encainide and flecainide, which suppressed ventricular arrhythmias, caused excess mortality; it covers the arrhythmia example only, not the HDL or glucose ones.
“patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo. The use of encainide and flecainide was discontinued because of excess mortality.”
- And the substitution risk is realized in documented cases where a drug improved the surrogate (suppressed arrhythmias, raised HDL, lowered glucose) while increasing mortality — the proxy moved the intended way and the target moved the opposite way, the exact catastrophe of treating a stand-in as the thing.
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