Harvey D. WhiteClaes HeldRalph StewartElizabeth TarkaRebekkah BrownRichard Y. DaviesAndrzej BudajRobert A. HarringtonP. Gabriel StegDiego ArdissinoPaul W. ArmstrongAlvaro AvezumPhilip E. AylwardAlfonso BryceHong ChenMing Fong ChenRamon CorbalanAnthony J. DalbyNicolas DanchinRobbert J. De WinterStefan DenchevRafael DiazMoses ElisafMarcus D. FlatherAssen R. GoudevChristopher B. GrangerLiliana GrinfeldJudith S. HochmanSteen HustedHyo Soo KimWolfgang KoenigAles LinhartEva LonnJosé López-SendónAthanasios J. ManolisEmile R. MohlerJosé C. NicolauPrem PaisAlexander ParkhomenkoTerje R. PedersenDaniel PellaMarco A. Ramos-CorralesMikhail RudaMátyás SeregSaulat SiddiquePeter SinnaevePeter SmithPiyamitr SritaraHenk P. SwartRody G. SyTamio TeramotoHung Fat TseDavid WatsonW. Douglas WeaverRobert WeissMargus ViigimaaDragos VinereanuJunren ZhuChristopher P. CannonLars WallentinUniversity of AucklandAkademiska SjukhusetGlaxoSmithKline, USADuke University Medical CenterSzpital Grochowski, WarszawaStanford UniversityInsermUniversite Paris 7- Denis DiderotUniversite Paris DescartesRoyal Brompton HospitalUniversita degli Studi di ParmaUniversity of AlbertaMcMaster University, Faculty of Health SciencesInstituto Dante Pazzanese de CardiologiaInstituto do Coracao do Hospital das ClinicasFlinders UniversityCardiogolf/Clinica El GolfPeking UniversityNational Taiwan University HospitalPontificia Universidad Catolica de ChileMilpark HospitalAcademic Medical Centre, University of AmsterdamUniversity Hospital AlexandrovskaEtudios Cardiologica Latin America, RosarioUniversity of Ioannina, School of MedicineNorwich Medical SchoolNorfolk and Norwich University Hospital NHS TrustUniversidad de Buenos AiresNYU Langone Medical CenterHospital Unit WestSeoul National University HospitalUniversitat UlmVeobecna Fakultni Nemocnice V PrazeCharles UniversityHospital Universitario La PazAsklepeion HospitalUniversity of PennsylvaniaSt. Johns Medical CollegeNational Scientific Center M.D. Strazhesko Institute of CardiologyUniversitetet i OsloPavol Jozef Safarik University in KosiceSan Jose Satelite HospitalNational Medical Research Center of Cardiology, MoscowSt. George's HospitalShaikh Zayed Postgraduate Medical InstituteKU Leuven– University Hospital LeuvenMahidol UniversitySt. Antonius ZiekenhuisUniversity of the Philippines ManilaTeikyo Academic Research CenterThe University of Hong KongHenry Ford Heart and Vascular InstituteMaine Research AssociatesTallinn University of TechnologyUniversitatea de Medicina si Farmacie Carol Davila din BucurestiFudan UniversityBrigham and Women's Hospital2018-11-092018-11-092014-01-01New England Journal of Medicine. Vol.370, No.18 (2014), 1702-171115334406002847932-s2.0-84899718423https://repository.li.mahidol.ac.th/handle/20.500.14594/34884BACKGROUND: 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.Mahidol UniversityMedicineArticleSCOPUS10.1056/NEJMoa1315878