Evacetrapib and Cardiovascular Outcomes in High-Risk Vascular Disease

BACKGROUND: The cholesteryl ester transfer protein inhibitor evacetrapib substantially raises the high-density lipoprotein (HDL) cholesterol level, reduces the low-density lipoprotein (LDL) cholesterol level, and enhances cellular cholesterol efflux capacity. We sought to determine the effect of evacetrapib on major adverse cardiovascular outcomes in patients with high-risk vascular disease. METHODS: In a multicenter, randomized, double-blind, placebo-controlled phase 3 trial, we enrolled 12,092 patients who had at least one of the following conditions: an acute coronary syndrome within the previous 30 to 365 days, cerebrovascular atherosclerotic disease, peripheral vascular arterial disease, or diabetes mellitus with coronary artery disease. Patients were randomly assigned to receive either evacetrapib at a dose of 130 mg or matching placebo, administered daily, in addition to standard medical therapy. The primary efficacy end point was the first occurrence of any component of the composite of death from cardiovascular causes, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina. RESULTS: At 3 months, a 31.1% decrease in the mean LDL cholesterol level was observed with evacetrapib versus a 6.0% increase with placebo, and a 133.2% increase in the mean HDL cholesterol level was seen with evacetrapib versus a 1.6% increase with placebo. After 1363 of the planned 1670 primary end-point events had occurred, the data and safety monitoring board recommended that the trial be terminated early because of a lack of efficacy. After a median of 26 months of evacetrapib or placebo, a primary end-point event occurred in 12.9% of the patients in the evacetrapib group and in 12.8% of those in the placebo group (hazard ratio, 1.01; 95% confidence interval, 0.91 to 1.11; P=0.91). CONCLUSIONS: Although the cholesteryl ester transfer protein inhibitor evacetrapib had favorable effects on established lipid biomarkers, treatment with evacetrapib did not result in a lower rate of cardiovascular events than placebo among patients with high-risk vascular disease. (Funded by Eli Lilly; ACCELERATE ClinicalTrials.gov number, NCT01687998 .)

Independent validation of Swarm Level2 magnetic field products and 'Quick Look' for Level 1b data

Magnetic field models are produced on behalf of the European Space Agency (ESA) by an independent scientific consortium known as the Swarm Satellite Constellation Application and Research Facility (SCARF), through the Level 2 Processor (L2PS). The consortium primarily produces magnetic field models for the core, lithosphere, ionosphere and magnetosphere. Typically, for each magnetic product, two magnetic field models are produced in separate chains using complementary data selection and processing techniques. Hence, the magnetic field models from the complementary processing chains will be similar but not identical. The final step in the overall L2PS therefore involves inspection and validation of the magnetic field models against each other and against data from (semi-) independent sources (e.g. ground observatories). We describe the validation steps for each magnetic field product and the comparison against independent datasets, and we show examples of the output of the validation. In addition, the L2PS also produces a daily set of `Quick Look' output graphics and statistics to monitor the overall quality of Level 1b data issued by ESA. We describe the outputs of the `Quick Look' chain