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 .)

CORPORATE RHETORIC OF THE ATOMIC POWER INDUSTRY AFTER THREE MILE ISLAND (MASS MEDIA, IMAGE, PUBLIC RELATIONS)

The accident at Three Mile Island altered dramatically the operating environment of the nuclear power industry. Realizing that public opinion would play a major role in determining the future of atomic power in this country, the industry embarked on a unified effort to resell the idea of nuclear energy. This study investigated the industry\u27s post-Three Mile Island advocacy campaign by examining the industry\u27s media environment from March 1979 to November 1980. These data indicated public relations damage caused by the accident, and how the industry reacted. The six research questions addressed in this study focused upon elements of how, and in what way the accident damaged the image of the nuclear power industry; how the industry responded; and what audiences were targeted during this campaign. This study found that the atomic power industry responded as a political actor after Three Mile Island. The industry\u27s rhetoric was designed to exert definitional control over the rhetorical situation by offering industry definitions of the events at Three Mile Island, and of the need for atomic power. The rhetorical strategies of purification and transcendence were used to illumine this rhetoric. This study examined the industry\u27s use of the specific tactics of newspaper advertisements, spokespersons, and pseudo events

“The meaning of Vietnam”: Political Rhetoric as Revisionist Cultural History

Secretary of State George P. Shultz delivered a speech entitled “The Meaning of Vietnam” in April 1985. This essay suggests that Shultz\u27s address provides an excellent case study for examining the rhetorical demands facing a politician offering a revisionist perspective on cultural history, potentially useful strategies for meeting those demands, and an opportunity to see how a troublesome past can be reframed to make it more “useful” in the present

Legitimating Liberal Credentials for the Presidency: John F. Kennedy and \u3cem\u3eThe Strategy of Peace\u3c/em\u3e

This study examines the rhetorical strategies in John F. Kennedy\u27s campaign book The Strategy of Peace. We isolate three rhetorical strategies: (a) evocation of an air of crisis and drift in foreign policy; (b) conveying a sense that the American people are defined by their “mission” and (c) making extensive, didactic use of historical analysis. We examine how these strategies focused toward establishing an image of effective leadership that would be particularly attractive to liberals within the Democratic party, and thus quiet their concerns about Kennedy\u27s presidential aspirations

Explaining It to Ourselves: The Phases of National Mourning in Space Tragedy

This essay relies on grief literature to develop a heuristic model of patterned stages of national mourning. This model is applied to lend insight into print mediated accounts of the explosion of the space shuttle Challenger

John F. Kennedy\u27s Civil Rights Discourse: The Evolution from “Principled Bystander” to Public Advocate

This essay argues that President John F. Kennedy\u27s civil rights discourse evidences an important evolutionary pattern marking a transition from legal argument to moral argument, and highlights two speeches as exemplars of this change. Three rhetorical constraints are identified which help account for and explain this shift in the president\u27s public rhetoric. Finally, we offer implications of this essay for the study of contemporary presidential discourse during times of domestic crisis

In a Perilous Hour: The Public Address of John F. Kennedy

This first book-length critical analysis of Kennedy\u27s public address defines how he aroused Americans to rise to the opportunities and challenges that he defined for them. This rigorously researched study offers an in-depth analysis of the development of President Kennedy as a public speaker and a balanced view of his civil rights, foreign policy, presidential, and other types of speeches. Eight speech texts accompany the analysis. This reference and teaching tool also offers a selected chronology of major speeches along with a bibliography of important primary and secondary sources. Designed for students, teachers, and professionals in the fields of rhetoric, political communication, presidential studies, and American history.https://epublications.marquette.edu/marq_fac-book/1153/thumbnail.jp