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 .)

The attitude behaviour relationship

Why should market researchers, advertisers and persuaders be concerned about experiments with a Chinese couple or a coal mining town in the States in the 1930's ? Or, care about the results of distraction, reactance and forced-compliance experiments conducted in psychological world laboratories around the world for the past fifty years? Why ? Because they are integrally bound into a very basic controversy - do attitudes predict behaviour or only mirror behaviour ? Consumer psychologists share with applied psychologists in other fields ¬education, personnel selection, child development, organisational behaviour, learning, social interaction, politics, therapy, interpersonal attraction, law and social work - a preoccupation with attitudes which hold a central position in their theories. Enormous amounts of time, energy and money have been expected in order to investigate the attitude-behaviour relationship

Motivational research - passing phrase or permanent feature?

In the first draft version of the paper on the Attitude-Behaviour Relationship (30th September, 1975) it was pointed out to readers that despite researchers' emphasis on understanding the "why" of consumer behaviour in order to complete the attitude-behaviour equation, the first paper would not deal with the subject of motivational research. This was because the history and theoretical bases for understanding the place of motivational research in modern psychological amd marketing thinking were significantly different from attitude theories and research techniques to warrant a separate and thorough treatment. Such diverse writers on the attitude-behaviour relationship as the market researchers Bird and Ehrenberg and the philosopher Audi were reported to have concluded their studies by stressing the motivational component as "largely responsible for the behaviour to which an attitude leads and which psychologists are concerned to predict."