Making sense of composite endpoints: efficiency, meaning and clinical relevance in modern cardiovascular trials

In this issue of Heart BMJ, Siquier-Padilla and colleagues present an up-to-date, timely and comprehensive review on a topic of utmost importance for cardiovascular research: composite endpoints in randomised clinical trials.1 In a field where declining event rates and escalating trial costs progressively challenge feasibility, the authors succinctly outline why composite endpoints have become ubiquitous, while critically exposing their conceptual, technical, clinical and statistical pitfalls. By doing so, the authors provide readers with a pragmatic framework for a more judicious interpretation of trial results.