OMT was associated with a significant reduction in mortality ( hazard ratio , 0.64 ; 95 % confidence interval , 0.48-0 .85 ; P = 0.002 ) and composite end point of death/myocardial infarction/stroke ( hazard ratio , 0.73 ; 95 % confidence interval , 0.58-0 .92 ; P = 0.007 ) at the 5-year follow-up .