27 research outputs found

    Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

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    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 .)

    Corrosion performance of Al-Si-Cu hypereutectic alloys in a synthetic condensed automotive solution

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    In this investigation the corrosion resistance of four Al-Si hypereutectic alloys in a solution typical of condensate from automotive fuel combustion products, and referred to here as synthetic condensed automotive solution, has been studied. Three commercial alloys that are used for cylinder liners, and a laboratory made alloy, were studied by electrochemical impedance spectroscopy and measurements were taken after increasing times of immersion in this solution. Comparison of the electrochemical response of the four alloys in the corrosive solution was carried out. Although the mechanisms by which the four alloys corroded were similar, the results indicated differences in corrosion resistances of these alloys, and these differences could be related to their microstructures. The laboratory prepared alloy showed increased susceptibility to pitting corrosion compared to the commercial alloys. The surfaces of the alloys were examined, before and after the corrosion test, by scanning electron microscopy and analyzed by energy dispersive spectroscopy. The results indicated preferential attack of the aluminium matrix phase in all the alloys. The alloy with higher copper content and prepared by spray forming was more susceptible to pitting compared to the other alloys. The EIS response at low frequencies indicated a diffusion-controlled process, probably that of oxygen to the alloy interface
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