Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Fanya Kaplan

Directed by: Brad Tucker ; Michael Gluzman, Screenplay: Wesley Wingo, Cinematography: Alan Melling, Original Score: Rolan Duvvury, Editing: Matt Bigelow ; James Murphy, Cast - Fanya Kaplan: Becky Tucker, Yuri: Michael Gluzman, Mikhail: Matt Perry, Cheka Officer: Nick Tecosky, Vladimir Lenin: Patrick Bradshaw, Suit #1: Ildar Musin, Suit #2: David Rutter, Suit #3: Rolan Duvvury, Firing Squad Officer: Brad Tucker, Crew - Chief Lighting Technician: Wryen Meek, Gaffer: Tamil Perisamy ; John Swisshelm ; Dave Lillethun, Best Boy: Ildar Musin, Camera Assistant: Amaris Gutierrez-Ray, Make up Artist: Becky Tucker, Costume Designer: Becky Tucker ; Brad Tucker ; Michael Gluzman, Sound Technician: Matt Bigelow, Boom Operator: Ildar Musin ; Tamil Perisamy ; Dave Lillethun, Translation: Yury Gluzman ; Michael Gluzman, Dialog Coach: Michael Gluzman ; Ildar Musin, Historical Consultant: Yury Gluzman, Foley Artist: Matt Bigelow, Assistant to Mrs. Tucker: John Swisshelm ; Jason King, Armorer: Alan Melling, "Varshavianka" Performed by: Yury Gluzman, Extras: Jonathan Diaz ; Michelle Vela ; Ignacio Becerra-Licha ; Emily Weigel ; Jason King ; Aaron May ; Nicole Rennalls ; James Murphy ; Tamil Perisamy ; Steven Sloan ; Troy Whyte ; James Ford ; Walker Kirkland ; Wryen Meek ; Dave Lillithun ; Terrill Turner, Special Thanks: Yury and Lyudmila Gluzman ; Alan Melling ; Travis Ekmark ; Walker Kirkland ; Drew Dickerson ; Wesley Wingo ; Wryen Meek ; Jason King ; Nick Tecosky ; John Swisshelm ; BuzzStudios ; Georgia Institute of Technology ; The City of Atlanta ; a 1.6.18 Films Production in coordination with: Xero Films ; Ey3 Soar Productions.Q & A session: http://hdl.handle.net/1853/14238Runtime: 06:35 minutesTake a trip back to revolutionary Russia, 1918. This Campus Moviefest award-winner revisits the fascinating story of Fanya Kaplan, a zealous socialist revolutionary, and her attempted assassination of Vladimir Leni