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Patients with end-stage renal disease often have derangements in calcium and phosphorus homeostasis and resultant secondary hyperparathyroidism (sHPT), which may contribute to the high prevalence of arterial stiffness and hypertension. We conducted a secondary analysis of the Evaluation of Cinacalcet Hydrochloride Therapy to Lower Cardiovascular Events (EVOLVE) trial, in which patients receiving hemodialysis with sHPT were randomly assigned to receive cinacalcet or placebo. We sought to examine whether the effect of cinacalcet on death and major cardiovascular events was modified by baseline pulse pressure as a marker of arterial stiffness, and whether cinacalcet yielded any effects on blood pressure. As reported previously, an unadjusted intention-to-treat analysis failed to conclude that randomization to cinacalcet reduces the risk of the primary composite end point (all-cause mortality or non-fatal myocardial infarction, heart failure, hospitalization for unstable angina or peripheral vascular event). However, after prespecified adjustment for baseline characteristics, patients randomized to cinacalcet experienced a nominally significant 13% lower adjusted risk (95% confidence limit 4–20%) of the primary composite end point. The effect of cinacalcet was not modified by baseline pulse pressure (Pinteraction=0.44). In adjusted models, at 20 weeks cinacalcet resulted in a 2.2 mm Hg larger average decrease in systolic blood pressure (P=0.002) and a 1.3 mm Hg larger average decrease in diastolic blood pressure (P=0.002) compared with placebo. In summary, in the EVOLVE trial, the effect of cinacalcet on death and major cardiovascular events was independent of baseline pulse pressure.

Fifty new ternary compounds Ln2T3Zn14 were isolated from alloys with a high zinc content by dissolving the zinc-rich matrix in hydrochloric acid. They crystallize with an ordered version of a binary structure type first reported for Th2Zn17. The structure of the ternaries was determined from four-circle X-ray diffractometer data of the four compounds Gd2Co3Zn14, Ce2Rh3Zn14, Pr2Ni3Zn14, and Sm2Pd3Zn14. It is rhombohedral, space group R&thremacr;m, with Z = 3 formula units in the corresponding hexagonal cell and the lattice constants a = 887.2(2) pm and c = 1300.2(3) pm for Gd2Co3Zn14. The transition metal atoms T are located essentially at one atomic site corresponding to the ideal occupancy in the compounds Gd2Co3Zn14 and Pr2Ni3Zn14. For the other two compounds significant deviations from the ideal composition could be observed for three of the four zinc sites of Th2Zn17, with mixed T/Zn occupancy, resulting in the compositions Ce2Rh1.90(2)Zn15.10(2) and Sm2Pd1.92(1)Zn15.08(1). The structure may be viewed as consisting of layers extending perpendicular to the hexagonal axis. One layer contains all of the rare earth atoms, the other all of the transition metal atoms, and both with additional zinc atoms, with unit mesh contents of Ln2Zn6 and T3Zn8. These layers alternate, corresponding to the formula Ln2Zn6·T3Zn8 = Ln2T3Zn14. The structure contains two kinds of voids. One of these is filled by carbon and nitrogen atoms in ternary magnetic materials Ln2Fe17C3-x and Ln2Fe17N3-x. The structure refinements show that both of these voids are unoccupied in the ternary zinc compounds Ln2T3Zn14. Similarly, a structure refinement of the known binary compound La2Zn17 did not reveal any significant amounts of impurity atoms (e.g., oxygen) at these voids. The refinement of the occupancy parameters for this compound resulted in the composition La2Zn16.06(6).