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Title: Darapladib for preventing ischemic events in stable coronary heart disease
Authors: Harvey D. White
Claes Held
Ralph Stewart
Elizabeth Tarka
Rebekkah Brown
Richard Y. Davies
Andrzej Budaj
Robert A. Harrington
P. Gabriel Steg
Diego Ardissino
Paul W. Armstrong
Alvaro Avezum
Philip E. Aylward
Alfonso Bryce
Hong Chen
Ming Fong Chen
Ramon Corbalan
Anthony J. Dalby
Nicolas Danchin
Robbert J. De Winter
Stefan Denchev
Rafael Diaz
Moses Elisaf
Marcus D. Flather
Assen R. Goudev
Christopher B. Granger
Liliana Grinfeld
Judith S. Hochman
Steen Husted
Hyo Soo Kim
Wolfgang Koenig
Ales Linhart
Eva Lonn
José López-Sendón
Athanasios J. Manolis
Emile R. Mohler
José C. Nicolau
Prem Pais
Alexander Parkhomenko
Terje R. Pedersen
Daniel Pella
Marco A. Ramos-Corrales
Mikhail Ruda
Mátyás Sereg
Saulat Siddique
Peter Sinnaeve
Peter Smith
Piyamitr Sritara
Henk P. Swart
Rody G. Sy
Tamio Teramoto
Hung Fat Tse
David Watson
W. Douglas Weaver
Robert Weiss
Margus Viigimaa
Dragos Vinereanu
Junren Zhu
Christopher P. Cannon
Lars Wallentin
University of Auckland
Akademiska Sjukhuset
GlaxoSmithKline, USA
Duke University Medical Center
Szpital Grochowski, Warszawa
Stanford University
Universite Paris 7- Denis Diderot
Universite Paris Descartes
Royal Brompton Hospital
Universita degli Studi di Parma
University of Alberta
McMaster University, Faculty of Health Sciences
Instituto Dante Pazzanese de Cardiologia
Instituto do Coracao do Hospital das Clinicas
Flinders University
Cardiogolf/Clinica El Golf
Peking University
National Taiwan University Hospital
Pontificia Universidad Catolica de Chile
Milpark Hospital
Academic Medical Centre, University of Amsterdam
University Hospital Alexandrovska
Etudios Cardiologica Latin America, Rosario
University of Ioannina, School of Medicine
Norwich Medical School
Norfolk and Norwich University Hospital NHS Trust
Universidad de Buenos Aires
NYU Langone Medical Center
Hospital Unit West
Seoul National University Hospital
Universitat Ulm
Veobecna Fakultni Nemocnice V Praze
Charles University
Hospital Universitario La Paz
Asklepeion Hospital
University of Pennsylvania
St. Johns Medical College
National Scientific Center M.D. Strazhesko Institute of Cardiology
Universitetet i Oslo
Pavol Jozef Safarik University in Kosice
San Jose Satelite Hospital
National Medical Research Center of Cardiology, Moscow
St. George's Hospital
Shaikh Zayed Postgraduate Medical Institute
KU Leuven– University Hospital Leuven
Mahidol University
St. Antonius Ziekenhuis
University of the Philippines Manila
Teikyo Academic Research Center
The University of Hong Kong
Henry Ford Heart and Vascular Institute
Maine Research Associates
Tallinn University of Technology
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
Fudan University
Brigham and Women's Hospital
Keywords: Medicine
Issue Date: 1-Jan-2014
Citation: New England Journal of Medicine. Vol.370, No.18 (2014), 1702-1711
Abstract: BACKGROUND: Elevated lipoprotein-associated phospholipase A2 activity promotes the development of vulnerable atherosclerotic plaques, and elevated plasma levels of this enzyme are associated with an increased risk of coronary events. Darapladib is a selective oral inhibitor of lipoprotein-associated phospholipase A2. METHODS: In a double-blind trial, we randomly assigned 15,828 patients with stable coronary heart disease to receive either once-daily darapladib (at a dose of 160 mg) or placebo. The primary end point was a composite of cardiovascular death, myocardial infarction, or stroke. Secondary end points included the components of the primary end point as well as major coronary events (death from coronary heart disease, myocardial infarction, or urgent coronary revascularization for myocardial ischemia) and total coronary events (death from coronary heart disease, myocardial infarction, hospitalization for unstable angina, or any coronary revascularization). RESULTS: During a median follow-up period of 3.7 years, the primary end point occurred in 769 of 7924 patients (9.7%) in the darapladib group and 819 of 7904 patients (10.4%) in the placebo group (hazard ratio in the darapladib group, 0.94; 95% confidence interval [CI], 0.85 to 1.03; P = 0.20). There were also no significant between-group differences in the rates of the individual components of the primary end point or in all-cause mortality. Darapladib, as compared with placebo, reduced the rate of major coronary events (9.3% vs. 10.3%; hazard ratio, 0.90; 95% CI, 0.82 to 1.00; P = 0.045) and total coronary events (14.6% vs. 16.1%; hazard ratio, 0.91; 95% CI, 0.84 to 0.98; P = 0.02). CONCLUSIONS: In patients with stable coronary heart disease, darapladib did not significantly reduce the risk of the primary composite end point of cardiovascular death, myocardial infarction, or stroke. Copyright © 2014 Massachusetts Medical Society.
ISSN: 15334406
Appears in Collections:Scopus 2011-2015

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