Effects of extended-release niacin with laropiprant in high-risk patients.
Martin J Landray,Richard Haynes,Jemma C. Hopewell,Sarah Parish,Theingi Aung,Joseph Tomson,K Wallendszus,Martin Craig,Lixin Jiang,Rory Collins,Jane Armitage +10 more
TLDR
Among participants with atherosclerotic vascular disease, the addition of extended-release niacin-laropiprant to statin-based LDL cholesterol-lowering therapy did not significantly reduce the risk of major vascular events but did increase therisk of serious adverse events.Abstract:
Background Patients with evidence of vascular disease are at increased risk for subsequent vascular events despite effective use of statins to lower the low-density lipoprotein (LDL) cholesterol level. Niacin lowers the LDL cholesterol level and raises the high-density lipoprotein (HDL) cholesterol level, but its clinical efficacy and safety are uncertain. Methods After a prerandomization run-in phase to standardize the background statin-based LDL cholesterol–lowering therapy and to establish participants' ability to take extended-release niacin without clinically significant adverse effects, we randomly assigned 25,673 adults with vascular disease to receive 2 g of extended-release niacin and 40 mg of laropiprant or a matching placebo daily. The primary outcome was the first major vascular event (nonfatal myocardial infarction, death from coronary causes, stroke, or arterial revascularization). Results During a median follow-up period of 3.9 years, participants who were assigned to extended-release niacin–laropiprant had an LDL cholesterol level that was an average of 10 mg per deciliter (0.25 mmol per liter as measured in the central laboratory) lower and an HDL cholesterol level that was an average of 6 mg per deciliter (0.16 mmol per liter) higher than the levels in those assigned to placebo. Assignment to niacin–laropiprant, as compared with assignment to placebo, had no significant effect on the incidence of major vascular events (13.2% and 13.7% of participants with an event, respectively; rate ratio, 0.96; 95% confidence interval [CI], 0.90 to 1.03; P=0.29). Niacin–laropiprant was associated with an increased incidence of disturbances in diabetes control that were considered to be serious (absolute excess as compared with placebo, 3.7 percentage points; Pandlt;0.001) and with an increased incidence of diabetes diagnoses (absolute excess, 1.3 percentage points; Pandlt;0.001), as well as increases in serious adverse events associated with the gastrointestinal system (absolute excess, 1.0 percentage point; Pandlt;0.001), musculoskeletal system (absolute excess, 0.7 percentage points; Pandlt;0.001), skin (absolute excess, 0.3 percentage points; P=0.003), and unexpectedly, infection (absolute excess, 1.4 percentage points; Pandlt;0.001) and bleeding (absolute excess, 0.7 percentage points; Pandlt;0.001). Conclusions Among participants with atherosclerotic vascular disease, the addition of extended-release niacin–laropiprant to statin-based LDL cholesterol–lowering therapy did not significantly reduce the risk of major vascular events but did increase the risk of serious adverse events. (Funded by Merck and others; HPS2-THRIVE ClinicalTrials.gov number, NCT00461630.)read more
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Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association
Emelia J. Benjamin,Paul Muntner,Alvaro Alonso,Márcio Sommer Bittencourt,Clifton W. Callaway,April P. Carson,Alanna M. Chamberlain,Alex R. Chang,Susan Cheng,Sandeep R Das,Francesca N. Delling,Luc Djoussé,Mitchell S.V. Elkind,Jane F. Ferguson,Myriam Fornage,Lori C. Jordan,Sadiya S. Khan,Brett M. Kissela,Kristen L. Knutson,Tak W. Kwan,Daniel T. Lackland,Tené T. Lewis,Judith H. Lichtman,Chris T. Longenecker,Matthew Shane Loop,Pamela L. Lutsey,Seth S. Martin,Kunihiro Matsushita,Andrew E. Moran,Michael E. Mussolino,Martin O'Flaherty,Ambarish Pandey,Amanda M. Perak,Wayne D. Rosamond,Gregory A. Roth,Uchechukwu K.A. Sampson,Gary Satou,Emily B. Schroeder,Svati H. Shah,Nicole L. Spartano,Andrew Stokes,David L. Tirschwell,Connie W. Tsao,Mintu P. Turakhia,Lisa B. VanWagner,John T. Wilkins,Sally S. Wong,Salim S. Virani +47 more
TL;DR: March 5, 2019 e1 WRITING GROUP MEMBERS Emelia J. Virani, MD, PhD, FAHA, Chair Elect On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee.
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2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular riskThe Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS)
François Mach,Colin Baigent,Alberico L. Catapano,Konstantinos C. Koskinas,Manuela Casula,Lina Badimon,M. John Chapman,Guy De Backer,Victoria Delgado,Brian A. Ference,Ian D. Graham,Alison Halliday,Ulf Landmesser,Borislava Mihaylova,Terje R. Pedersen,Gabriele Riccardi,Dimitrios J. Richter,Marc S. Sabatine,Marja-Riitta Taskinen,Lale Tokgozoglu,Olov Wiklund,Christian Mueller,Heinz Drexel,Victor Aboyans,Alberto Corsini,Wolfram Doehner,Michel Farnier,Bruna Gigante,Meral Kayıkçıoğlu,Goran Krstacic,Ekaterini Lambrinou,Basil S. Lewis,Josep Masip,Philippe Moulin,Steffen E. Petersen,Anna Sonia Petronio,Massimo F Piepoli,Xavier Pintó,Lorenz Räber,Kausik K. Ray,Željko Reiner,Walter F Riesen,Marco Roffi,Jean-Paul Schmid,Evgeny Shlyakhto,Iain A. Simpson,Erik S.G. Stroes,Isabella Sudano,Alexandros D Tselepis,Margus Viigimaa,Cecile Vindis,Alexander Vonbank,Michal Vrablik,Mislav Vrsalovic,José Luis Zamorano,Jean-Philippe Collet,Stephan Windecker,Veronica Dean,Donna Fitzsimons,Chris P Gale,Diederick E. Grobbee,Sigrun Halvorsen,Gerhard Hindricks,Bernard Iung,Peter Jüni,Hugo A. Katus,Christophe Leclercq,Maddalena Lettino,Béla Merkely,Miguel Sousa-Uva,Rhian M. Touyz,Djamaleddine Nibouche,Parounak H. Zelveian,Peter Siostrzonek,Ruslan Najafov,Philippe van de Borne,Belma Pojskic,Arman Postadzhiyan,Lambros Kypris,Jindřich Špinar,Mogens Lytken Larsen,Hesham Salah Eldin,Timo E. Strandberg,Jean Ferrières,Rusudan Agladze,Ulrich Laufs,Loukianos S. Rallidis,Laszlo Bajnok,Thorbjorn Gudjonsson,Vincent Maher,Yaakov Henkin,Michele Massimo Gulizia,Aisulu Mussagaliyeva,Gani Bajraktari,Alina Kerimkulova,Gustavs Latkovskis,Omar Hamoui,Rimvydas Šlapikas,Laurent Visser,P. Dingli,Victoria Ivanov,Aneta Boskovic,Mbarek Nazzi,Frank L.J. Visseren,Irena Mitevska,Kjetil Retterstøl,Piotr Jankowski,Ricardo Fontes-Carvalho,Dan Gaita,Marat V. Ezhov,Marina Foscoli,Vojislav Giga,Daniel Pella,Zlatko Fras,Leopoldo Pérez de Isla,Emil Hagström,Roger Lehmann,Leila Abid,Oner Ozdogan,Olena Mitchenko,Riyaz S. Patel +120 more
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Ezetimibe added to statin therapy after acute coronary syndromes
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2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk
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TL;DR: Authors/Task Force Members (François Macha, Colin Baigentb,∗∗,2, Alberico L. Catapanoc), ESC Committee for Practice Guidelines (CPG) (Stephan Windeckeraa), ESC National Cardiac Societies (Djamaleddine Nibouchean, Parounak H. Patelcl)
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2016 ESC/EAS Guidelines for the Management of Dyslipidaemias
Alberico L. Catapano,Ian D. Graham,Guy De Backer,Olov Wiklund,M. John Chapman,Heinz Drexel,Arno W. Hoes,Catriona Jennings,Ulf Landmesser,Terje R. Pedersen,Željko Reiner,Gabriele Riccardi,Marja-Riitta Taskinen,Lale Tokgozoglu,W. M. Monique Verschuren,Charalambos Vlachopoulos,David R. Wood,José Luis Zamorano +17 more
TL;DR: The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology and European Atherosclerosis Society and EAS and ABI : ankle-brachial index are formed.
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