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 .)

Acquired Horner's Syndrome as a Presenting Sign of Dilatative Arteriopathy in PHACE Syndrome

We report a case of acquired Horner's syndrome associated with an increase in calibre of the internal carotid artery (ICA) in a child with PHACE (Posterior fossa brain malformations, Hemangioma, Arterial anomalies, Cardiac defect and aortic coarctation, Eye abnormalities) syndrome

Distributed phased arrays and wireless beamforming networks

The article of record as published may be found at http://dx.doi.org/10.1080/15501320701863635Distributed phased arrays have advantages over conventional arrays in many radar and communication applications. Additional advantages are realized by replacing the microwave beamforming circuit by a wireless network, thus forming a wirelessly networked distributed sensor array. This article examines various aspects of a distributed phased array that incorporates wireless beamforming. First, the fundamental array theory and digital signal processing are reviewed. Basic equations are presented and compared to simulations for a ship-based radar application. Next the basic array architecture is described and the critical techniques and components that are required to realize the design are discussed. Methods are introduced for time and phase synchronization, transmit-receive isolation, sensor location issues, and bandwidth and frequency dispersion

Causes, functional outcomes and healthcare utilisation of people with cerebral palsy in Singapore

10.47102/annals-acadmedsg.2020489ANNALS ACADEMY OF MEDICINE SINGAPORE50