Composite Endpoint
A clinical trial outcome that combines multiple individual events into a single measure. MACE (major adverse cardiovascular events) — combining cardiovascular death, non-fatal heart attack, and non-fatal stroke — is a common composite endpoint in cardiovascular outcomes trials for metabolic peptide drugs.
Technical Context
MACE (major adverse cardiovascular events) is the standard composite endpoint for cardiovascular outcomes trials: 3-point MACE = cardiovascular death + non-fatal myocardial infarction + non-fatal stroke; 4-point MACE adds hospitalisation for unstable angina. Composite endpoints increase event rates (improving statistical power with smaller samples/shorter follow-up) but individual components may not contribute equally and may even move in different directions. The SELECT trial (semaglutide 2.4mg for cardiovascular risk reduction in obesity) showed a 20% reduction in 3-point MACE, with the benefit driven primarily by non-fatal MI and non-fatal stroke reduction. Careful analysis of individual components is essential when interpreting composite results.