the benchmark for assessing future coronary risk; the risk in patients with prior MI (in whom the rate of new MI is 20 per 1000 patient-years) is generally considered as sufficiently high to clearly warrant ongoing statin treatment.12 Most national guidelines for the general population also recommend universal or very liberal use of statin treatment among those with coronary risk that is lower than those with prior MI (but still substantially higher than average), such as those with diabetes or prior stroke.12,24 26 There is no consensus on the level of future coronary risk that is sufficient to justify statin treatment, but in the judgment of the Work Group rates of coronary death or non-fatal MI o10 per 1000 patient-years are unlikely to be broadly accepted as an indication for treatment. The rate of coronary death or incident MI among patients with CKD (defined by eGFR 15 59.9 ml/min/1.73 m2 or with heavy proteinuria) is similar to or higher than those with diabetes (with or without CKD).27 However, the risk associated with CKD is age-dependent. For example, the rate of coronary death or incident MI among CKD patients aged 450 years (both men and women) is consistently greater than 10 per 1000 patient-years, even in those without diabetes or prior MI) (Figure 2; Table 3). In contrast, the rate of coronary death or incident MI among CKD patients aged r50 years is low in those without diabetes or prior MI (Figure 2) although it is higher than in otherwise comparable people without CKD. Further inspection of the absolute risks indicate that participants aged 40 50 years have average rates of CHD death or incident MI that are consistently less than 10 per 1000 patient-years. Case-fatality rate following myocardial infarction. 