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ConclusionsCompared with gemcitabine, first-line folfirinox significantly prolongs median os. Given the favourable cost per qaly, the improvement in clinical efficacy, and the limited available treatment options, folfirinox represents an attractive cost-effective treatment for mpc.

These data contribute to our understanding of contemporary trends in the management of patients with HeFH in Canada. Despite a majority of patients receiving LLT, few patients reached high-risk lipid targets. These data highlight important opportunities to improve the care of patients with HeFH.

Purpose -The purpose of this paper is to docoment a randomized controlled trial, with follow-up at three and six months, to determine the impact of a coronary risk factor modification program for employees. Design/methodology/approach -Intervention participants received a 12-week health promotion program involving exercise, education seminars, nutritional analysis and smoking cessation counselling. Outcome measures included differences in coronary risk factors of control and intervention participants between baseline and three and six-month follow-up visits. Findings -The participants included 566 individuals employed in the Halifax area, Nova Scotia, Canada. They were between 19 and 66 years old with at least two modifiable coronary risk factors. There were statistically significant differences at three months in coronary risk score improvement, smoking cessation, physical activity level increases, body mass index reductions and serum cholesterol. At six months, improvements remained significant except for cholesterol. Reduction in blood pressure was not significantly different. Intervention participants compared to control participants showed significant differences in both cardiac and stroke risk at three and six-month visits.Practical implications -This study demonstrates that employees had a significant coronary disease risk reduction as a result of a relatively short health promotion intervention. Benefits three months post-intervention were not sustained to the same extent as during the intervention. This underscores the need for long-term commitment with lifestyle changes and raises the issue of the need for a comprehensive approach that also addresses environmental factors. Originality/value -This paper contributes to the current research base on this topic as there are few well-designed studies to reduce coronary risk factors for employees.