The Evolution of Black Hole Mass and Spin in Active Galactic Nuclei

We argue that supermassive black hole growth in AGN occurs via sequences of randomly--oriented accretion discs with angular momentum limited by self--gravity. These stably co-- or counter--align with the black hole spin with almost equal frequency. Accretion from these discs very rapidly adjusts the hole's spin parameter to average values $\bar a \sim 0.1-0.3$ (the precise range depending slightly on the disc vertical viscosity coefficient $\alpha_2$) from any initial conditions, but with significant fluctuations ($\Delta a\sim \pm 0.2$) about these. We conclude (a) AGN black holes should on average spin moderately, with the mean value $\bar a$ decreasing slowly as the mass increases; (b) SMBH coalescences leave little long--term effect on $\bar a$; (c) SMBH coalescence products in general have modest recoil velocities, so that there is little likelihood of their being ejected from the host galaxy; (d) black holes can grow even from stellar masses to \sim 5\times 10^9 \msun at high redshift $z\sim 6$; (e) jets produced in successive accretion episodes can have similar directions, but after several episodes the jet direction deviates significantly. Rare examples of massive holes with larger spin parameters could result from prograde coalescences with SMBH of similar mass, and are most likely to be found in giant ellipticals. We compare these results with observation. (abridged)Comment: MNRAS, in pres

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 .)