Search

Your search keyword '"Byington, R."' showing total 192 results
Start Over Author "Byington, R."
192 results on '"Byington, R."'

1. Age-stratified and blood-pressure-stratified effects of blood-pressure-lowering pharmacotherapy for the prevention of cardiovascular disease and death: an individual participant-level data meta-analysis

Author

Rahimi, K, Bidel, Z, Nazarzadeh, M, Copland, E, Canoy, D, Wamil, M, Majert, J, Mcmanus, R, Adler, A, Agodoa, L, Algra, A, Asselbergs, F, Beckett, N, Berge, E, Black, H, Boersma, E, Brouwers, F, Brown, M, Brugts, J, Bulpitt, C, Byington, R, Cushman, W, Cutler, J, Devereaux, R, Dwyer, J, Estacio, R, Fagard, R, Fox, K, Fukui, T, Gupta, A, Holman, R, Imai, Y, Ishii, M, Julius, S, Kanno, Y, Kjeldsen, S, Kostis, J, Kuramoto, K, Lanke, J, Lewis, E, Lewis, J, Lievre, M, Lindholm, L, Lueders, S, Macmahon, S, Mancia, G, Matsuzaki, M, Mehlum, M, Nissen, S, Ogawa, H, Ogihara, T, Ohkubo, T, Palmer, C, Patel, A, Pfeffer, M, Pitt, B, Poulter, N, Rakugi, H, Reboldi, G, Reid, C, Remuzzi, G, Ruggenenti, P, Saruta, T, Schrader, J, Schrier, R, Sever, P, Sleight, P, Staessen, J, Suzuki, H, Thijs, L, Ueshima, K, Umemoto, S, van Gilst, W, Verdecchia, P, Wachtell, K, Whelton, P, Wing, L, Woodward, M, Yui, Y, Yusuf, S, Zanchetti, A, Zhang, Z, Anderson, C, Baigent, C, Brenner, B, Collins, R, de Zeeuw, D, Lubsen, J, Malacco, E, Neal, B, Perkovic, V, Rodgers, A, Rothwell, P, Salimi-Khorshidi, G, Sundstrom, J, Turnbull, F, Viberti, G, Wang, J, Chalmers, J, Davis, B, Pepine, C, Teo, K, Rahimi K., Bidel Z., Nazarzadeh M., Copland E., Canoy D., Wamil M., Majert J., McManus R., Adler A., Agodoa L., Algra A., Asselbergs F. W., Beckett N. S., Berge E., Black H., Boersma E., Brouwers F. P. J., Brown M., Brugts J. J., Bulpitt C. J., Byington R. P., Cushman W. C., Cutler J., Devereaux R. B., Dwyer J. P., Estacio R., Fagard R., Fox K., Fukui T., Gupta A. K., Holman R. R., Imai Y., Ishii M., Julius S., Kanno Y., Kjeldsen S. E., Kostis J., Kuramoto K., Lanke J., Lewis E., Lewis J. B., Lievre M., Lindholm L. H., Lueders S., MacMahon S., Mancia G., Matsuzaki M., Mehlum M. H., Nissen S., Ogawa H., Ogihara T., Ohkubo T., Palmer C. R., Patel A., Pfeffer M. A., Pitt B., Poulter N. R., Rakugi H., Reboldi G., Reid C., Remuzzi G., Ruggenenti P., Saruta T., Schrader J., Schrier R., Sever P., Sleight P., Staessen J. A., Suzuki H., Thijs L., Ueshima K., Umemoto S., van Gilst W. H., Verdecchia P., Wachtell K., Whelton P., Wing L., Woodward M., Yui Y., Yusuf S., Zanchetti A., Zhang Z. -Y., Anderson C., Baigent C., Brenner B. M., Collins R., de Zeeuw D., Lubsen J., Malacco E., Neal B., Perkovic V., Rodgers A., Rothwell P., Salimi-Khorshidi G., Sundstrom J., Turnbull F., Viberti G., Wang J., Chalmers J., Davis B. R., Pepine C. J., Teo K. K., Rahimi, K, Bidel, Z, Nazarzadeh, M, Copland, E, Canoy, D, Wamil, M, Majert, J, Mcmanus, R, Adler, A, Agodoa, L, Algra, A, Asselbergs, F, Beckett, N, Berge, E, Black, H, Boersma, E, Brouwers, F, Brown, M, Brugts, J, Bulpitt, C, Byington, R, Cushman, W, Cutler, J, Devereaux, R, Dwyer, J, Estacio, R, Fagard, R, Fox, K, Fukui, T, Gupta, A, Holman, R, Imai, Y, Ishii, M, Julius, S, Kanno, Y, Kjeldsen, S, Kostis, J, Kuramoto, K, Lanke, J, Lewis, E, Lewis, J, Lievre, M, Lindholm, L, Lueders, S, Macmahon, S, Mancia, G, Matsuzaki, M, Mehlum, M, Nissen, S, Ogawa, H, Ogihara, T, Ohkubo, T, Palmer, C, Patel, A, Pfeffer, M, Pitt, B, Poulter, N, Rakugi, H, Reboldi, G, Reid, C, Remuzzi, G, Ruggenenti, P, Saruta, T, Schrader, J, Schrier, R, Sever, P, Sleight, P, Staessen, J, Suzuki, H, Thijs, L, Ueshima, K, Umemoto, S, van Gilst, W, Verdecchia, P, Wachtell, K, Whelton, P, Wing, L, Woodward, M, Yui, Y, Yusuf, S, Zanchetti, A, Zhang, Z, Anderson, C, Baigent, C, Brenner, B, Collins, R, de Zeeuw, D, Lubsen, J, Malacco, E, Neal, B, Perkovic, V, Rodgers, A, Rothwell, P, Salimi-Khorshidi, G, Sundstrom, J, Turnbull, F, Viberti, G, Wang, J, Chalmers, J, Davis, B, Pepine, C, Teo, K, Rahimi K., Bidel Z., Nazarzadeh M., Copland E., Canoy D., Wamil M., Majert J., McManus R., Adler A., Agodoa L., Algra A., Asselbergs F. W., Beckett N. S., Berge E., Black H., Boersma E., Brouwers F. P. J., Brown M., Brugts J. J., Bulpitt C. J., Byington R. P., Cushman W. C., Cutler J., Devereaux R. B., Dwyer J. P., Estacio R., Fagard R., Fox K., Fukui T., Gupta A. K., Holman R. R., Imai Y., Ishii M., Julius S., Kanno Y., Kjeldsen S. E., Kostis J., Kuramoto K., Lanke J., Lewis E., Lewis J. B., Lievre M., Lindholm L. H., Lueders S., MacMahon S., Mancia G., Matsuzaki M., Mehlum M. H., Nissen S., Ogawa H., Ogihara T., Ohkubo T., Palmer C. R., Patel A., Pfeffer M. A., Pitt B., Poulter N. R., Rakugi H., Reboldi G., Reid C., Remuzzi G., Ruggenenti P., Saruta T., Schrader J., Schrier R., Sever P., Sleight P., Staessen J. A., Suzuki H., Thijs L., Ueshima K., Umemoto S., van Gilst W. H., Verdecchia P., Wachtell K., Whelton P., Wing L., Woodward M., Yui Y., Yusuf S., Zanchetti A., Zhang Z. -Y., Anderson C., Baigent C., Brenner B. M., Collins R., de Zeeuw D., Lubsen J., Malacco E., Neal B., Perkovic V., Rodgers A., Rothwell P., Salimi-Khorshidi G., Sundstrom J., Turnbull F., Viberti G., Wang J., Chalmers J., Davis B. R., Pepine C. J., and Teo K. K.

Abstract

Background: The effects of pharmacological blood-pressure-lowering on cardiovascular outcomes in individuals aged 70 years and older, particularly when blood pressure is not substantially increased, is uncertain. We compared the effects of blood-pressure-lowering treatment on the risk of major cardiovascular events in groups of patients stratified by age and blood pressure at baseline. Methods: We did a meta-analysis using individual participant-level data from randomised controlled trials of pharmacological blood-pressure-lowering versus placebo or other classes of blood-pressure-lowering medications, or between more versus less intensive treatment strategies, which had at least 1000 persons-years of follow-up in each treatment group. Participants with previous history of heart failure were excluded. Data were obtained from the Blood Pressure Lowering Treatment Triallists' Collaboration. We pooled the data and categorised participants into baseline age groups (<55 years, 55–64 years, 65–74 years, 75–84 years, and ≥85 years) and blood pressure categories (in 10 mm Hg increments from <120 mm Hg to ≥170 mm Hg systolic blood pressure and from <70 mm Hg to ≥110 mm Hg diastolic). We used a fixed effects one-stage approach and applied Cox proportional hazard models, stratified by trial, to analyse the data. The primary outcome was defined as either a composite of fatal or non-fatal stroke, fatal or non-fatal myocardial infarction or ischaemic heart disease, or heart failure causing death or requiring hospital admission. Findings: We included data from 358 707 participants from 51 randomised clinical trials. The age of participants at randomisation ranged from 21 years to 105 years (median 65 years [IQR 59–75]), with 42 960 (12·0%) participants younger than 55 years, 128 437 (35·8%) aged 55–64 years, 128 506 (35·8%) 65–74 years, 54 016 (15·1%) 75–84 years, and 4788 (1·3%) 85 years and older. The hazard ratios for the risk of major cardiovascular events per 5 mm Hg

Published
2021

2. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis

Author

Adler, A, Agodoa, L, Algra, A, Asselbergs, F, Beckett, N, Berge, E, Black, H, Brouwers, F, Brown, M, Bulpitt, C, Byington, R, Chalmers, J, Cushman, W, Cutler, J, Davis, B, Devereaux, R, Dwyer, J, Estacio, R, Fagard, R, Fox, K, Fukui, T, Gupta, A, Holman, R, Imai, Y, Ishii, M, Julius, S, Kanno, Y, Kjeldsen, S, Kostis, J, Kuramoto, K, Lanke, J, Lewis, E, Lewis, J, Lievre, M, Lindholm, L, Lueders, S, Macmahon, S, Mancia, G, Matsuzaki, M, Mehlum, M, Nissen, S, Ogawa, H, Ogihara, T, Ohkubo, T, Palmer, C, Patel, A, Pepine, C, Pfeffer, M, Pitt, B, Poulter, N, Rakugi, H, Reboldi, G, Reid, C, Remuzzi, G, Ruggenenti, P, Saruta, T, Schrader, J, Schrier, R, Sever, P, Sleight, P, Staessen, J, Suzuki, H, Thijs, L, Ueshima, K, Umemoto, S, van Gilst, W, Verdecchia, P, Wachtell, K, Whelton, P, Wing, L, Woodward, M, Yui, Y, Yusuf, S, Zanchetti, A, Zhang, Z, Anderson, C, Baigent, C, Brenner, B, Collins, R, de Zeeuw, D, Lubsen, J, Malacco, E, Neal, B, Perkovic, V, Rodgers, A, Rothwell, P, Salimi-Khorshidi, G, Sundstrom, J, Turnbull, F, Viberti, G, Wang, J, Adler A., Agodoa L., Algra A., Asselbergs F. W., Beckett N. S., Berge E., Black H., Brouwers F. P. J., Brown M., Bulpitt C. J., Byington R. P., Chalmers J., Cushman W. C., Cutler J., Davis B. R., Devereaux R. B., Dwyer J., Estacio R., Fagard R., Fox K., Fukui T., Gupta A. K., Holman R. R., Imai Y., Ishii M., Julius S., Kanno Y., Kjeldsen S. E., Kostis J., Kuramoto K., Lanke J., Lewis E., Lewis J. B., Lievre M., Lindholm L. H., Lueders S., MacMahon S., Mancia G., Matsuzaki M., Mehlum M. H., Nissen S., Ogawa H., Ogihara T., Ohkubo T., Palmer C. R., Patel A., Pepine C. J., Pfeffer M. A., Pitt B., Poulter N. R., Rakugi H., Reboldi G., Reid C., Remuzzi G., Ruggenenti P., Saruta T., Schrader J., Schrier R., Sever P., Sleight P., Staessen J. A., Suzuki H., Thijs L., Ueshima K., Umemoto S., van Gilst W. H., Verdecchia P., Wachtell K., Whelton P., Wing L., Woodward M., Yui Y., Yusuf S., Zanchetti A., Zhang Z. -Y., Anderson C., Baigent C., Brenner B. M., Collins R., de Zeeuw D., Lubsen J., Malacco E., Neal B., Perkovic V., Rodgers A., Rothwell P., Salimi-Khorshidi G., Sundstrom J., Turnbull F., Viberti G., Wang J., Adler, A, Agodoa, L, Algra, A, Asselbergs, F, Beckett, N, Berge, E, Black, H, Brouwers, F, Brown, M, Bulpitt, C, Byington, R, Chalmers, J, Cushman, W, Cutler, J, Davis, B, Devereaux, R, Dwyer, J, Estacio, R, Fagard, R, Fox, K, Fukui, T, Gupta, A, Holman, R, Imai, Y, Ishii, M, Julius, S, Kanno, Y, Kjeldsen, S, Kostis, J, Kuramoto, K, Lanke, J, Lewis, E, Lewis, J, Lievre, M, Lindholm, L, Lueders, S, Macmahon, S, Mancia, G, Matsuzaki, M, Mehlum, M, Nissen, S, Ogawa, H, Ogihara, T, Ohkubo, T, Palmer, C, Patel, A, Pepine, C, Pfeffer, M, Pitt, B, Poulter, N, Rakugi, H, Reboldi, G, Reid, C, Remuzzi, G, Ruggenenti, P, Saruta, T, Schrader, J, Schrier, R, Sever, P, Sleight, P, Staessen, J, Suzuki, H, Thijs, L, Ueshima, K, Umemoto, S, van Gilst, W, Verdecchia, P, Wachtell, K, Whelton, P, Wing, L, Woodward, M, Yui, Y, Yusuf, S, Zanchetti, A, Zhang, Z, Anderson, C, Baigent, C, Brenner, B, Collins, R, de Zeeuw, D, Lubsen, J, Malacco, E, Neal, B, Perkovic, V, Rodgers, A, Rothwell, P, Salimi-Khorshidi, G, Sundstrom, J, Turnbull, F, Viberti, G, Wang, J, Adler A., Agodoa L., Algra A., Asselbergs F. W., Beckett N. S., Berge E., Black H., Brouwers F. P. J., Brown M., Bulpitt C. J., Byington R. P., Chalmers J., Cushman W. C., Cutler J., Davis B. R., Devereaux R. B., Dwyer J., Estacio R., Fagard R., Fox K., Fukui T., Gupta A. K., Holman R. R., Imai Y., Ishii M., Julius S., Kanno Y., Kjeldsen S. E., Kostis J., Kuramoto K., Lanke J., Lewis E., Lewis J. B., Lievre M., Lindholm L. H., Lueders S., MacMahon S., Mancia G., Matsuzaki M., Mehlum M. H., Nissen S., Ogawa H., Ogihara T., Ohkubo T., Palmer C. R., Patel A., Pepine C. J., Pfeffer M. A., Pitt B., Poulter N. R., Rakugi H., Reboldi G., Reid C., Remuzzi G., Ruggenenti P., Saruta T., Schrader J., Schrier R., Sever P., Sleight P., Staessen J. A., Suzuki H., Thijs L., Ueshima K., Umemoto S., van Gilst W. H., Verdecchia P., Wachtell K., Whelton P., Wing L., Woodward M., Yui Y., Yusuf S., Zanchetti A., Zhang Z. -Y., Anderson C., Baigent C., Brenner B. M., Collins R., de Zeeuw D., Lubsen J., Malacco E., Neal B., Perkovic V., Rodgers A., Rothwell P., Salimi-Khorshidi G., Sundstrom J., Turnbull F., Viberti G., and Wang J.

Abstract

Background: The effects of pharmacological blood pressure lowering at normal or high-normal blood pressure ranges in people with or without pre-existing cardiovascular disease remains uncertain. We analysed individual participant data from randomised trials to investigate the effects of blood pressure lowering treatment on the risk of major cardiovascular events by baseline levels of systolic blood pressure. Methods: We did a meta-analysis of individual participant-level data from 48 randomised trials of pharmacological blood pressure lowering medications versus placebo or other classes of blood pressure-lowering medications, or between more versus less intensive treatment regimens, which had at least 1000 persons-years of follow-up in each group. Trials exclusively done with participants with heart failure or short-term interventions in participants with acute myocardial infarction or other acute settings were excluded. Data from 51 studies published between 1972 and 2013 were obtained by the Blood Pressure Lowering Treatment Trialists' Collaboration (Oxford University, Oxford, UK). We pooled the data to investigate the stratified effects of blood pressure-lowering treatment in participants with and without prevalent cardiovascular disease (ie, any reports of stroke, myocardial infarction, or ischaemic heart disease before randomisation), overall and across seven systolic blood pressure categories (ranging from <120 to ≥170 mm Hg). The primary outcome was a major cardiovascular event (defined as a composite of fatal and non-fatal stroke, fatal or non-fatal myocardial infarction or ischaemic heart disease, or heart failure causing death or requiring admission to hospital), analysed as per intention to treat. Findings: Data for 344 716 participants from 48 randomised clinical trials were available for this analysis. Pre-randomisation mean systolic/diastolic blood pressures were 146/84 mm Hg in participants with previous cardiovascular disease (n=157 728) and 157/8

Published
2021

4. One‐Year Landmark Analysis of the Effect of Beta‐Blocker Dose on Survival After Acute Myocardial Infarction

Author

Goldberger, Jeffrey J., primary, Subačius, Haris, additional, Marroquin, Oscar C., additional, Beau, Scott L., additional, Simonson, Jay, additional, Desai, P., additional, Betzen, M., additional, DeLuna, D., additional, Whitehill, J., additional, Hatch, J., additional, Janak, L., additional, Cherry, R., additional, Gonzalez, E., additional, Cruz, I., additional, Johnson, E., additional, Allbritton, C., additional, Derrick, V., additional, Fishman, R., additional, Assalone, V., additional, Mahon, L., additional, Lustgarten, D., additional, Rowen, M., additional, Bessette, M., additional, Alemy, B., additional, Dan, D., additional, Picardi, K., additional, Schuger, C., additional, Dzidowski, J., additional, McCarthy, M., additional, Fields, P., additional, Alexander, S., additional, Nair, G., additional, Kovacs, R., additional, Beasley, D., additional, Strickland, T., additional, Marks, J., additional, Beau, S., additional, Tableriou, J., additional, Griffin, B., additional, Shani, J., additional, Stokes‐McCarthy, M., additional, Tan‐Augenstein, G., additional, Pace, G., additional, Brosnan, H., additional, Hayes, J., additional, Mancl, K., additional, Maassen, K., additional, Fintel, D., additional, Karpf, L., additional, Abraham, T., additional, Campione, K., additional, Martin, E., additional, Bello, D., additional, Viera Fleetwood, I., additional, Tinetti, M., additional, Rock, R., additional, Simonson, J., additional, Barnes, S., additional, Letexier, J., additional, Strothman, M., additional, Mattson, J., additional, Albert Shoultz, C., additional, Ali, S., additional, Abbott, D., additional, Medeiros, M., additional, McKeon, J., additional, Nichols, A., additional, Edwards, T., additional, Watts, C., additional, Alley, C., additional, Romanelli, M., additional, Steffen, D., additional, Henschel, R., additional, Teller, S., additional, Froehlich, L., additional, Bess, R., additional, Warnica, W., additional, Smith, B., additional, Eichman, D., additional, Scarcelli, D., additional, Badhwar, N., additional, Malone, P., additional, Green, D., additional, Iyer, S., additional, Germany, R., additional, Murray, C., additional, Straughn, G., additional, Drennan, K., additional, Marroquin, O., additional, Dennis, L., additional, Farrow, C., additional, Baxendell, L., additional, Grate, S., additional, Enlow, M., additional, Zareba, W., additional, Chaudhary, I., additional, Laduke, P., additional, Conary‐Rocco, V., additional, Caufield, L., additional, Patterson, C., additional, Warner, A., additional, Johnson, J., additional, Germano, J., additional, Drewes, W., additional, George, B., additional, Yoo, B., additional, Patel, D., additional, Bonow, R., additional, Cuffe, M., additional, Dyer, A., additional, Greenland, P., additional, Goldberger, J., additional, O’Rourke, R., additional, Rosenberg, Y., additional, Shah, P., additional, Byington, R., additional, Feng, Z., additional, Goldstein, S., additional, Kirkpatrick, J., additional, Love, C., additional, Singh, S., additional, Goldberg, S., additional, Kwak, M., additional, Rao, A., additional, Srinivas, P., additional, Ball, C., additional, Cahill, J., additional, Schaechter, A., additional, Alexander, D., additional, Ma, K., additional, Plant, T., additional, Rosenfeld, A., additional, Scofic, J., additional, Simon, J., additional, and Subačius, H., additional

Published
2021
Full Text
View/download PDF

11. Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials

Author

Fulcher, J, Mihaylova, B, O'Connell, R, Emberson, J, Blackwell, L, Reith, C, Koren, M, Tonkin, A, Ridker, P, Barnes, E, Ford, I, Kean, S, Trompet, S, Macfarlane, P, Cannon, C, Pedersen, TR, Wilhelmsen, L, LaRosa, J, Packard, C, Robertson, M, Young, R, Tobert, J, Flather, M, Goto, S, Kastelein, J, Newman, C, Shear, C, Varigos, J, White, H, Armitage, J, Davies, K, Halls, H, Harper, C, Herrington, W, Holland, L, Kirby, A, Oconnell, R, Preiss, D, Spata, E, Wilson, K, Lonn, E, Wanner, C, Koenig, W, Gotto, A, Kjekshus, J, Yusuf, S, Collins, R, Simes, J, Baigent, C, Keech, A, De Lemos, J, Braunwald, E, Blazing, M, Murphy, S, Downs, JR, Clearfield, M, Holdaas, H, Gordon, D, Davis, B, Dahlof, B, Poulter, N, Sever, P, Knopp, RH, Fellstrom, B, Jardine, A, Schmieder, R, Zannad, F, Colhoun, HM, Betteridge, DJ, Durrington, PN, Hitman, GA, Fuller, J, Neil, A, Sacks, F, Moye, L, Pfeffer, M, Hawkins, CM, Wedel, H, Wikstrand, J, Krane, V, Tavazzi, L, Maggioni, A, Marchioli, R, Tognoni, G, Franzosi, MG, Bowman, L, Landray, MJ, Parish, S, Peto, R, Sleight, P, Ridker, PM, Macmahon, S, Marschner, I, Shaw, J, Serruys, PW, Nakamura, H, Knatterud, G, Furberg, C, Byington, R, Sattar, N, and Jukema, JW

Subjects
medicine.medical_specialty, Statin, medicine.drug_class, Atorvastatin, 030204 cardiovascular system & hematology, ATORVASTATIN, PURLs®, Rate ratio, Article, 03 medical and health sciences, 0302 clinical medicine, Medicine, General & Internal, Risk Factors, Internal medicine, General & Internal Medicine, medicine, Humans, Rosuvastatin, CORONARY-HEART-DISEASE, 030212 general & internal medicine, Myocardial infarction, ROSUVASTATIN, Stroke, ELDERLY-PATIENTS, Aged, Randomized Controlled Trials as Topic, Aged, 80 and over, RISK, Science & Technology, Cholesterol Treatment Trialists' Collaboration, Vascular disease, business.industry, CHOLESTEROL, Age Factors, General Medicine, 11 Medical And Health Sciences, medicine.disease, R1, 3. Good health, LOWERING THERAPY, Regimen, MYOCARDIAL-INFARCTION, Cardiovascular Diseases, CARDIOVASCULAR-DISEASE, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business, PRIMARY PREVENTION, Life Sciences & Biomedicine, medicine.drug
Abstract

Background: Statin therapy has been shown to reduce major vascular events and vascular mortality in a wide range of individuals, but there is uncertainty about its efficacy and safety among older people. We undertook a meta-analysis of data from all large statin trials to compare the effects of statin therapy at different ages.Methods: In this meta-analysis, randomised trials of statin therapy were eligible if they aimed to recruit at least 1000 participants with a scheduled treatment duration of at least 2 years. We analysed individual participant data from 22 trials (n=134 537) and detailed summary data from one trial (n=12 705) of statin therapy versus control, plus individual participant data from five trials of more intensive versus less intensive statin therapy (n=39 612). We subdivided participants into six age groups (55 years or younger, 56–60 years, 61–65 years, 66–70 years, 71–75 years, and older than 75 years). We estimated effects on major vascular events (ie, major coronary events, strokes, and coronary revascularisations), cause-specific mortality, and cancer incidence as the rate ratio (RR) per 1·0 mmol/L reduction in LDL cholesterol. We compared proportional risk reductions in different age subgroups by use of standard χ2 tests for heterogeneity when there were two groups, or trend when there were more than two groups.Findings: 14 483 (8%) of 186 854 participants in the 28 trials were older than 75 years at randomisation, and the median follow-up duration was 4·9 years. Overall, statin therapy or a more intensive statin regimen produced a 21% (RR 0·79, 95% CI 0·77–0·81) proportional reduction in major vascular events per 1·0 mmol/L reduction in LDL cholesterol. We observed a significant reduction in major vascular events in all age groups. Although proportional reductions in major vascular events diminished slightly with age, this trend was not statistically significant (ptrend=0·06). Overall, statin or more intensive therapy yielded a 24% (RR 0·76, 95% CI 0·73–0·79) proportional reduction in major coronary events per 1·0 mmol/L reduction in LDL cholesterol, and with increasing age, we observed a trend towards smaller proportional risk reductions in major coronary events (ptrend=0·009). We observed a 25% (RR 0·75, 95% CI 0·73–0·78) proportional reduction in the risk of coronary revascularisation procedures with statin therapy or a more intensive statin regimen per 1·0 mmol/L lower LDL cholesterol, which did not differ significantly across age groups (ptrend=0·6). Similarly, the proportional reductions in stroke of any type (RR 0·84, 95% CI 0·80–0·89) did not differ significantly across age groups (ptrend=0·7). After exclusion of four trials which enrolled only patients with heart failure or undergoing renal dialysis (among whom statin therapy has not been shown to be effective), the trend to smaller proportional risk reductions with increasing age persisted for major coronary events (ptrend=0·01), and remained non-significant for major vascular events (ptrend=0·3). The proportional reduction in major vascular events was similar, irrespective of age, among patients with pre-existing vascular disease (ptrend=0·2), but appeared smaller among older than among younger individuals not known to have vascular disease (ptrend=0·05). We found a 12% (RR 0·88, 95% CI 0·85–0·91) proportional reduction in vascular mortality per 1·0 mmol/L reduction in LDL cholesterol, with a trend towards smaller proportional reductions with older age (ptrend=0·004), but this trend did not persist after exclusion of the heart failure or dialysis trials (ptrend=0·2). Statin therapy had no effect at any age on non-vascular mortality, cancer death, or cancer incidence.Interpretation: Statin therapy produces significant reductions in major vascular events irrespective of age, but there is less direct evidence of benefit among patients older than 75 years who do not already have evidence of occlusive vascular disease. This limitation is now being addressed by further trials.Funding: Australian National Health and Medical Research Council, National Institute for Health Research Oxford Biomedical Research Centre, UK Medical Research Council, and British Heart Foundation.

Published
2019
Full Text
View/download PDF

13. Blood pressure lowering and major cardiovascular events in people with and without chronic kidney disease: meta-analysis of randomised controlled trials

Author

Agodoa, L, Anderson, C, Asselbergs, FW, Baigent, C, Black, H, Brenner, B, Brown, M, Bulpitt, C, Byington, R, Chalmers, J, Collins, R, Cutler, J, Dahlof, B, Davis, B, de Zeeuw, D, Dens, J, Estacio, R, Fagard, R, Fox, K, Fukui, T, Hansson, L, Holman, R, Hunsicker, L, Imai, Y, Ishii, M, Kanno, Y, Kostis, J, Kuramoto, K, Lewis, E, Lievre, M, Lindholm, LH, Liu, L, Lubsen, J, Lueders, S, MacMahon, S, Malacco, E, Mancia, G, Matsuzaki, M, Neal, B, Nissen, S, Ohkubo, T, Ogihara, T, Pepine, C, Pfeffer, M, Pitt, B, Poole-Wilson, P, Poulter, N, Rahman, M, Remme, W, Remuzzi, G, Rodgers, A, Ruggenenti, P, Saruta, T, Schrader, J, Schrier, R, Sever, P, Sleight, P, Staessen, J, Suzuki, H, Teo, K, van Gilst, WH, Viberti, G, Wang, J, Whelton, P, Wing, L, Yui, Y, Yusuf, S, Zanchetti, A, Barzi, F, Heritier, S, Li, N, Ninomiya, T, Perkovic, V, Turnbull, F, Woodward, M, Wilson, K, Kearney, ACP, Gallagher, M, Cass, A, Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Cardiology, Clinical Research Unit, Pathology, Graduate School, ACS - Heart failure & arrhythmias, and Amsterdam Reproduction & Development (AR&D)

Subjects
medicine.medical_specialty, Hemodynamics, Renal function, CONVERTING ENZYME-INHIBITOR, PLACEBO-CONTROLLED TRIAL, CALCIUM-ANTAGONIST, DOUBLE-BLIND, HYPERTENSIVE PATIENTS, RISK-FACTOR, Internal medicine, medicine, Myocardial infarction, Intensive care medicine, PUBLICATION BIAS, biology, business.industry, Research, Angiotensin-converting enzyme, General Medicine, medicine.disease, RENAL OUTCOMES, Blood pressure, ATHEROSCLEROSIS, Heart failure, Cardiology, Aortic pressure, biology.protein, CORONARY-ARTERY-DISEASE, business, Kidney disease
Abstract

Objective To define the cardiovascular effects of lowering blood pressure in people with chronic kidney disease.Design Collaborative prospective meta-analysis of randomised trials.Data sources and eligibility Participating randomised trials of drugs to lower blood pressure compared with placebo or each other or that compare different blood pressure targets, with at least 1000 patient years of follow-up per arm.Main outcome measures Major cardiovascular events (stroke, myocardial infarction, heart failure, or cardiovascular death) in composite and individually and all cause death.Participants 26 trials (152 290 participants), including 30 295 individuals with reduced estimated glomerular filtration rate (eGFR), which was defined as eGFRData extraction Individual participant data were available for 23 trials, with summary data from another three. Meta-analysis according to baseline kidney function was performed. Pooled hazard ratios per 5 mm Hg lower blood pressure were estimated with a random effects model.Results Compared with placebo, blood pressure lowering regimens reduced the risk of major cardiovascular events by about a sixth per 5 mm Hg reduction in systolic blood pressure in individuals with (hazard ratio 0.83, 95% confidence interval 0.76 to 0.90) and without reduced eGFR (0.83, 0.79 to 0.88), with no evidence for any difference in effect (P=1.00 for homogeneity). The results were similar irrespective of whether blood pressure was reduced by regimens based on angiotensin converting enzyme inhibitors, calcium antagonists, or diuretics/beta blockers. There was no evidence that the effects of different drug classes on major cardiovascular events varied between patients with different eGFR (all P>0.60 for homogeneity).Conclusions Blood pressure lowering is an effective strategy for preventing cardiovascular events among people with moderately reduced eGFR. There is little evidence from these overviews to support the preferential choice of particular drug classes for the prevention of cardiovascular events in chronic kidney disease.

Published
2016
Full Text
View/download PDF

15. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials

Author

Mihaylova, B., Emberson, J., Blackwell, L., Keech, A., Simes, J., Barnes, E.H., Voysey, M., Gray, A., Collins, R., Baigent, C., Lemos, J. de, Braunwald, E., Blazing, M., Murphy, S., Downs, J.R., Gotto, A., Clearfield, M., Holdaas, H., Gordon, D., Davis, B., Koren, M., Dahlof, B., Poulter, N., Sever, P., Knopp, R.H., Fellstrom, B., Jardine, A., Schmieder, R., Zannad, F., Goldbourt, U., Kaplinsky, E., Colhoun, H.M., Betteridge, D.J., Durrington, P.N., Hitman, G.A., Fuller, J., Neil, A., Wanner, C., Krane, V., Sacks, F., Moye, L., Pfeffer, M., Hawkins, C.M., Kjekshus, J., Wedel, H., Wikstrand, J., Barter, P., Tavazzi, L., Maggioni, A., Marchioli, R., Tognoni, G., Franzosi, M.G., Bloomfield, H., Robins, S., Armitage, J., Parish, S., Peto, R., Sleight, P., Pedersen, T.R., Ridker, P.M., Holman, R., Meade, T., MacMahon, S., Marschner, I., Tonkin, A., Shaw, J., Serruys, P.W., Nakamura, H., Knatterud, G., Furberg, C., Byington, R., Macfarlane, P., Cobbe, S., Ford, I., Murphy, M., Blauw, G.J., Packard, C., Shepherd, J., Pedersen, T., Wilhelmsen, L., Cannon, C., Bowman, L., Landray, M., Rosa, J. la, Rossouw, J., Probstfield, J., and Cholesterol Treatment Trialists

Published
2012

16. Blood pressure-dependent and independent effects of agents that inhibit the renin-angiotensin system

Author

Agodoa, L, Anderson, C, Asseibergs, F, Baigent, C, Black, H, Brenner, B, Brown, M, Bulpitt, C, Byington, R, Chalmers, J, Collins, R, Cutler, J, Dahlof, B, Davis, B, de Zeeuw, D, Dens, J, Estacio, R, Fagard, Robert, Fox, K, Fukui, T, Hansson, L, Holman, R, Hunsicker, L, Imai, Y, Ishii, M, Kanno, Y, Kostis, J, Kuramoto, K, Lewis, E, Lievre, M, Lindholm, LH, Liu-Huang, Li-chuan, Lubsen, J, Lueders, S, MacMahon, S, Malacco, E, Mancia, G, Matsuzaki, M, Neal, B, Nissen, S, Ohkubo, T, Ogihara, T, Pepine, C, Pfeffer, M, Pitt, B, Poole-Wilson, P, Rahman, M, Remme, W, Remuzzi, G, Rodgers, A, Ruggenenti, P, Saruta, T, Schrader, J, Schrier, R, Sever, P, Sleight, P, Staessen, Jan A, Teo, K, Viberti, G, Wang, J, Whelton, P, Wing, L, Yui, Y, Yusuf, S, Zanchetti, A, Swedberg, K, Kjekshus, J, Algert, C, Perkovic, V, Turnbull, F, Woodward, M, and Groningen Kidney Center (GKC)

Subjects
coronary-artery-disease, Physiology, CONVERTING-ENZYME-INHIBITORS, converting-enzyme-inhibitors, Placebo-controlled study, heart failure, Angiotensin-Converting Enzyme Inhibitors, high-risk patients, 030204 cardiovascular system & hematology, PLACEBO-CONTROLLED TRIAL, Renin-Angiotensin System, Coronary artery disease, 0302 clinical medicine, placebo-controlled trial, HYPERTENSIVE PATIENTS, 030212 general & internal medicine, prospectively-designed overviews, Stroke, Randomized Controlled Trials as Topic, major cardiovascular events, blood pressure, stroke, CHRONIC HEART-FAILURE, 3. Good health, Cardiovascular Diseases, randomized controlled-trial, Cardiology, ventricular systolic function, Cardiology and Cardiovascular Medicine, meta-regression analyses, RECEPTOR BLOCKERS, medicine.medical_specialty, Placebo, Sensitivity and Specificity, 03 medical and health sciences, VENTRICULAR SYSTOLIC FUNCTION, Internal medicine, Renin–angiotensin system, Internal Medicine, medicine, Humans, CARDIOVASCULAR MORBIDITY, cardiovascular diseases, coronary heart disease, HIGH-RISK PATIENTS, lipid-lowering treatment, business.industry, medicine.disease, RANDOMIZED-TRIAL, chronic heart-failure, Blood pressure, MYOCARDIAL-INFARCTION, meta-analyses, Relative risk, Heart failure, business, Angiotensin II Type 1 Receptor Blockers
Abstract

Objectives To evaluate the blood pressure-dependent and independent effects of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) on major cardiovascular events.Methods Using data from 26 large-scale trials comparing an ACEI or an ARB with placebo or another drug class, meta-regression analyses were conducted in which treatment-specific relative risks for major cause-specific outcomes [stroke, major coronary heart disease (CHD) events and heart failure] were regressed against follow-up blood pressure differences.Results From a total of 146 838 individuals with high blood pressure or an elevated risk of cardiovascular disease, 22 666 major cardiovascular events were documented during follow-up. The analyses showed comparable blood pressure-dependent reductions in risk with ACEI and ARB (P > 0.3 for all three outcomes). The analyses also showed that ACEI produced a blood pressure-independent reduction in the relative risk of CHD of approximately 9% (95% confidence interval 3-14%). No similar effect was detected for ARB, and there was some evidence of a difference between ACEI and ARB in this regard (P =0.002). For both stroke and heart failure there was no evidence of any blood pressure-independent effects of either ACEI or ARB.Conclusion There are similar blood pressure-dependent effects of ACEI and ARB for the risks of stroke, CHD and heart failure. For ACEI, but not ARB, there is evidence of blood pressure-independent effects on the risk of major coronary disease events.

Published
2007

17. Validation of the EBMT risk score in chronic myeloid leukemia in Brazil and allogeneic transplant outcome

Author

Carmino De Souza, Vigorito, A. C., Ruiz, M. A., Nucci, M., Dulley, F. L., Funcke, V., Tabak, D., Azevedo, A. M., Byington, R., Macedo, M. C., Saboya, R., Aranha, F. J. P., Oliveira, G. B., Zulli, R., Miranda, E. C. M., Azevedo, W. M., Lodi, F. M., Voltarelli, J. C., Simões, B. P., Colturato, V., Souza, M. P., Silla, L., Bittencourt, H., Piron-Ruiz, L., Maiolino, A., Gratwohl, A., and Pasquini, R.

Subjects
Adult, Male, Risk, Adolescent, Hematopoietic Stem Cell Transplantation, Infant, Middle Aged, Disease-Free Survival, Sex Factors, Treatment Outcome, Child, Preschool, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Humans, Transplantation, Homologous, Female, Child, Brazil, Retrospective Studies
Abstract

The management of chronic myeloid leukemia (CML) has changed radically since the introduction of imatinib therapy. The decision of whether to offer a patient a hematopoietic stem cell transplant (HSCT) must be based on the probability of success of the procedure. The aim of this retrospective analysis of 1,084 CML patients who received an allogeneic HSCT in 10 Brazilian Centers between February 1983 and March 2003 was to validate the EBMT risk score.The study population comprised 647 (60%) males and 437 (40%) females, with a median age of 32 years old (range 1 - 59); 898 (83%) were in chronic phase, 146 (13%) were in accelerated phase and 40 (4%) were in blast crisis; 151 (14%) were younger than 20 years old, 620 (57%) were between 20 and 40 and 313 (29%) were older than 40; 1,025 (94%) received an HLA fully matched sibling transplant and only 59 (6%) received an unrelated transplant. In 283 cases (26%) a male recipient received a graft from a female donor. The interval from diagnosis to transplantation was less than 12 months in 223 (21%) cases and greater in 861 (79%). The overall survival, disease-free survival, transplant-related mortality and relapse incidence were 49%, 50%, 45% and 25%, respectively.Of the 1084 patients, 179 (17%) had a risk score of 0 or 1, 397 (37%) had a score of 2, 345 (32%) had a score of 3, 135 (12%) had a score of 4 and 28 (2%) a score of 5 or 6. The overall survival (OS) rate in patients with risk scores 0-1 and 2 was similar (58% and 55%, respectively) but significantly better than that in patients with scores 3 or more (score 3 - 44%, 4 - 36 % and 5-6 - 27%, respectively) pp0.001). Disease-free survival (DFS) and transplant related mortality (TRM) in a patients with a score of 3 or more were 46% and 49%, respectively and the relapse rate beyond score 5-6 was 77%. Disease status had a negative impact on all outcomes (OS, DFS, TRM, and relapse). The OS rate for male recipients of a graft from a female donor was 40% compared to 52% among the other donor-recipient pairs (p=0.004). DFS and TRM were significant for disease phase and female donor-male recipient (p0.001 and p0.003, respectively). In our experience, age and interval between diagnosis and transplant did influence OS, DFS, TRM, and relapse rate.Our results validate the EBMT risk score in the context of a developing country and confirm its usefulness for making point decisions in the imatinib era.

Published
2005

18. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials

Author

Turnbull, F, Neal, B, Algert, C, Chalmers, J, Woodward, M, MacMahon, S, Baigent, C, Cutler, J, Fagard, Robert, Whelton, P, Yusuf, Satara, Chapman, N, Agodoa, L, Black, H, Boissel, JP, Brenner, B, Brown, M, Bulpitt, C, Byington, R, Collins, R, Dahlof, B, Davis, B, Dens, Joseph, Estacio, R, Fox, K, Hansson, L, Holman, R, Hunsicker, L, Kostis, J, Kuramoto, K, Lewis, E, Lindholm, L, Lubsen, J, Malacco, E, Mancia, G, Pepine, C, Pfeffer, M, Pitt, B, Poole-Wilson, P, Remuzzi, G, Rodgers, A, Ruggenenti, P, Schrier, R, Sever, P, Sleight, P, Staessen, Jan A, Tco, K, Turner, R, Wing, L, Yui, Y, and Zanchetti, A

Subjects
Male, microvascular complications, medicine.medical_specialty, medicine.drug_class, Adrenergic beta-Antagonists, converting-enzyme-inhibitor, Angiotensin-Converting Enzyme Inhibitors, morbidity, Calcium channel blocker, Disease, Pharmacology, outcomes, Risk Assessment, Placebos, Angiotensin Receptor Antagonists, Internal medicine, medicine, Humans, Prospective Studies, Prospective cohort study, Diuretics, Antihypertensive Agents, Aged, Randomized Controlled Trials as Topic, Heart Failure, business.industry, coronary heart-disease, General Medicine, antihypertensive therapies, Middle Aged, medicine.disease, Calcium Channel Blockers, isolated systolic hypertension, mortality, Regimen, Blood pressure, Treatment Outcome, Cardiovascular Diseases, Relative risk, Heart failure, Hypertension, Female, double-blind, Risk assessment, business, calcium-channel blocker
Abstract

BACKGROUND: The benefits of reducing blood pressure on the risks of major cardiovascular disease are well established, but uncertainty remains about the comparative effects of different blood-pressure-lowering regimens. We aimed to estimate effects of strategies based on different drug classes (angiotensin-converting-enzyme [ACE] inhibitors, calcium antagonists, angiotensin-receptor blockers [ARBs], and diuretics or beta blockers) or those targeting different blood pressure goals, on the risks of major cardiovascular events and death. METHODS: We did seven sets of prospectively-designed overviews with data from 29 randomised trials (n=162341). The trial eligibility criteria, primary outcomes, and main hypotheses were specified before the result of any contributing trial was known. FINDINGS: In placebo-controlled trials the relative risks of total major cardiovascular events were reduced by regimens based on ACE inhibitors (22%; 95% CI 17-27) or calcium antagonists (18%; 5-29). Greater risk reductions were produced by regimens that targeted lower blood pressure goals (15%; 5-24). ARB-based regimens reduced the risks of total major cardiovascular events (10%; 4-17) compared with control regimens. There were no significant differences in total major cardiovascular events between regimens based on ACE inhibitors, calcium antagonists, or diuretics or beta blockers, although ACE-inhibitor-based regimens reduced blood pressure less. There was evidence of some differences between active regimens in their effects on cause-specific outcomes. For every outcome other than heart failure, the difference between randomised groups in achieved blood pressure reduction was directly related to the observed difference in risk. INTERPRETATION: Treatment with any commonly-used regimen reduces the risk of total major cardiovascular events, and larger reductions in blood pressure produce larger reductions in risk.

Published
2003

19. Lack of effect of lowering LDL cholesterol on cancer: Meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy

Author

Emberson, JR, Kearney, PM, Blackwell, L, Newman, C, Reith, C, Bhala, N, Holland, L, Peto, R, Keech, A, Collins, R, Simes, J, Baigent, C, De Lemos, J, Braunwald, E, Blazing, M, Murphy, S, Downs, JR, Gotto, A, Clearfield, M, Holdaas, H, Gordon, D, Davis, B, Koren, M, Dahlof, B, Poulter, N, Sever, P, Knopp, RH, Fellström, B, Jardine, A, Schmieder, R, Zannad, F, Goldbourt, U, Kaplinsky, E, Colhoun, HM, Betteridge, DJ, Durrington, PN, Hitman, GA, Fuller, J, Neil, A, Wanner, C, Krane, V, Sacks, F, Moyé, L, Pfeffer, M, Hawkins, CM, Kjekshus, J, Wedel, H, Wikstrand, J, Tavazzi, L, Maggioni, A, Marchioli, R, Tognoni, G, Franzosi, MG, Armitage, J, Parish, S, Sleight, P, Pedersen, TR, Ridker, PM, MacMahon, S, Marschner, I, Tonkin, A, Shaw, J, Serruys, PW, Nakamura, H, Knatterud, G, Furberg, C, Byington, R, Macfarlane, P, Cobbe, S, Ford, I, Murphy, M, Blauw, GJ, Packard, C, Shepherd, J, Wilhelmsen, L, Cannon, C, Bowman, L, La Rosa, J, Flather, M, Kastelein, J, Shear, C, Tobert, J, Varigos, J, White, H, Yusuf, S, Baxter, A, Barnes, EH, Buck, G, Herrington, WG, Kirby, A, Lewis, DA, Mellies, M, McGovern, M, Barclay, J, Belder, R, Mitchell, Y, Musliner, T, Ansquer, JC, Llewellyn, M, Bortolini, M, Emberson, JR, Kearney, PM, Blackwell, L, Newman, C, Reith, C, Bhala, N, Holland, L, Peto, R, Keech, A, Collins, R, Simes, J, Baigent, C, De Lemos, J, Braunwald, E, Blazing, M, Murphy, S, Downs, JR, Gotto, A, Clearfield, M, Holdaas, H, Gordon, D, Davis, B, Koren, M, Dahlof, B, Poulter, N, Sever, P, Knopp, RH, Fellström, B, Jardine, A, Schmieder, R, Zannad, F, Goldbourt, U, Kaplinsky, E, Colhoun, HM, Betteridge, DJ, Durrington, PN, Hitman, GA, Fuller, J, Neil, A, Wanner, C, Krane, V, Sacks, F, Moyé, L, Pfeffer, M, Hawkins, CM, Kjekshus, J, Wedel, H, Wikstrand, J, Tavazzi, L, Maggioni, A, Marchioli, R, Tognoni, G, Franzosi, MG, Armitage, J, Parish, S, Sleight, P, Pedersen, TR, Ridker, PM, MacMahon, S, Marschner, I, Tonkin, A, Shaw, J, Serruys, PW, Nakamura, H, Knatterud, G, Furberg, C, Byington, R, Macfarlane, P, Cobbe, S, Ford, I, Murphy, M, Blauw, GJ, Packard, C, Shepherd, J, Wilhelmsen, L, Cannon, C, Bowman, L, La Rosa, J, Flather, M, Kastelein, J, Shear, C, Tobert, J, Varigos, J, White, H, Yusuf, S, Baxter, A, Barnes, EH, Buck, G, Herrington, WG, Kirby, A, Lewis, DA, Mellies, M, McGovern, M, Barclay, J, Belder, R, Mitchell, Y, Musliner, T, Ansquer, JC, Llewellyn, M, and Bortolini, M

Abstract

© 2012 CTT Collaboration. Background: Statin therapy reduces the risk of occlusive vascular events, but uncertainty remains about potential effects on cancer. We sought to provide a detailed assessment of any effects on cancer of lowering LDL cholesterol (LDL-C) with a statin using individual patient records from 175,000 patients in 27 large-scale statin trials. Methods and Findings: Individual records of 134,537 participants in 22 randomised trials of statin versus control (median duration 4.8 years) and 39,612 participants in 5 trials of more intensive versus less intensive statin therapy (median duration 5.1 years) were obtained. Reducing LDL-C with a statin for about 5 years had no effect on newly diagnosed cancer or on death from such cancers in either the trials of statin versus control (cancer incidence: 3755 [1.4% per year [py]] versus 3738 [1.4% py], RR 1.00 [95% CI 0.96-1.05]; cancer mortality: 1365 [0.5% py] versus 1358 [0.5% py], RR 1.00 [95% CI 0.93-1.08]) or in the trials of more versus less statin (cancer incidence: 1466 [1.6% py] vs 1472 [1.6% py], RR 1.00 [95% CI 0.93-1.07]; cancer mortality: 447 [0.5% py] versus 481 [0.5% py], RR 0.93 [95% CI 0.82-1.06]). Moreover, there was no evidence of any effect of reducing LDL-C with statin therapy on cancer incidence or mortality at any of 23 individual categories of sites, with increasing years of treatment, for any individual statin, or in any given subgroup. In particular, among individuals with low baseline LDL-C (<2 mmol/L), there was no evidence that further LDL-C reduction (from about 1.7 to 1.3 mmol/L) increased cancer risk (381 [1.6% py] versus 408 [1.7% py]; RR 0.92 [99% CI 0.76-1.10]). Conclusions: In 27 randomised trials, a median of five years of statin therapy had no effect on the incidence of, or mortality from, any type of cancer (or the aggregate of all cancer).

Published
2012

20. Survival of HIV-infected patients after starting tuberculosis treatment: a prospective cohort study

Author

Maruza, M., primary, Albuquerque, M. F. P. M., additional, Braga, M. C., additional, Barbosa, M. T. S., additional, Byington, R., additional, Coimbra, I., additional, Moura, L. V., additional, Batista, J. D. L., additional, Diniz, G. T. N., additional, Miranda-Filho, D. B., additional, Lacerda, H. R., additional, Rodrigues, L. C., additional, and Ximenes, R. A. A., additional

Published
2012
Full Text
View/download PDF

21. The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study

Author

Bonds, D. E, primary, Miller, M. E, additional, Bergenstal, R. M, additional, Buse, J. B, additional, Byington, R. P, additional, Cutler, J. A, additional, Dudl, R J., additional, Ismail-Beigi, F., additional, Kimel, A. R, additional, Hoogwerf, B., additional, Horowitz, K. R, additional, Savage, P. J, additional, Seaquist, E. R, additional, Simmons, D. L, additional, Sivitz, W. I, additional, Speril-Hillen, J. M, additional, and Sweeney, M. E., additional

Published
2010
Full Text
View/download PDF

33. BMI percentile a potential tool for predicting pediatric obstructive sleep apnea.

Author

Keene S, Mohon R, Samples D, Masini D, and Byington R

Abstract

Many physicians are reluctant to order overnight polysomnography studies in children to definitively diagnose sleeping disorders because of a lack of expertise in the field, high cost of the examination, or inducing the anxiety of separating the child from its family. The study questioned what if any relationship existed between body mass index (BMI) percentile and pédiatric obstructive sleepapnea, and if so, can BMI percentile be used as an additional screening tool (in conjunction with primary snoring) to warrant polysomnography testing. The relevance of discovering such a relationship would be the addition of a noninvasive diagnostic trigger useful to clinicians, specifically pediatricians, as a differential to the diagnosis of OSA. This trigger wotild add validity to ordering polysomnography testing to diagnose or rule out OSA in pédiatrie patients. We performed a retrospective chart review of 158 pédiatric patients who were tested for OSA in a pédiatric sleep laboratory in Northeast Tennessee. Of those 158 patients undergoing overnight polysomnography, 129 were found to be positive for OSA. Of the 129 positive for OSA, 117 were at the tails of the distribution for BMI and fell in the less than fifth percentile for body mass index (BMI) or greater than the ninety-fifth percentile for BMI. This study was significant using the one way Chi Square method (Alpha=.O5, p=.77O). The significance of these findings to clinical practice in pediatrics is that in conjunction with primary snoring, OSA may be predicted by looking at the child's BMI percentile. If the child's BMI percentile is less than the 5th percentile or greater than the 95th percentile, overnight polysomnography is indicated when considering a diagnosis of OSA. [ABSTRACT FROM AUTHOR]

Published
2010

46. Phenotypic Analysis of New World Primate Mononuclear Cell Surface Antigens

Author

Schooley, R. T., Byington, R., and Falk, L. A.

Abstract

We have applied a panel of monoclonal antibodies against antigens present on the surface of human mononuclear cells to the study of mononuclear cell surface antigens expressed by seven species of New World primates. Antibodies to the sheep erythrocyte receptor (OKT11a) to a thymocyte antigen (OKT10), to the I region of the major histocompatibility locus (OKIa), and to an antigen found on the surface of human monocytes (OKM1) cross‐reacted with mononuclear cell surface antigens of most of the species studied. Antibodies to antigens which have been correlated with functional capabilities in the human system (OKT4, OKT5, OKT8, 3A1) were much less reactive with platyrrhine mononuclear cells. These reagents may be quite useful in studies of primate phylogeny and immunology.

Published
1983
Full Text
View/download PDF

47. Detection of human T-cell lymphotropic virus type III-related antigens and anti-human T-cell lymphotropic virus type III antibodies by anticomplementary immunofluorescence

Author

Blumberg, R S, Sandstrom, E G, Paradis, T J, Neumeyer, D N, Sarngadharan, M G, Hartshorn, K L, Byington, R E, Hirsch, M S, and Schooley, R T

Abstract

Techniques presently available for detection of human T-cell lymphotropic virus type III (HTLV-III) antigens and antibodies are laborious or relatively nonsensitive. We adapted anticomplementary immunofluorescence (ACIF) for these purposes. In HTLV-III-infected cells, specific ACIF was demonstrated by a diffuse speckling pattern that often resulted in a peripheral cellular rim of fluorescence. A 97% concordance was demonstrated between the ACIF assay and other sensitive tests for HTLV-III antibody detection (Western blot and membrane immunofluorescence and fixed-cell immunofluorescence tests). The ACIF assay was both more sensitive and more specific when compared with the enzyme-linked immunosorbent assay. For detection of HTLV-III antigens, the ACIF assay appeared to be as sensitive as the reverse transcriptase assay and more sensitive, with less background reactivity, than the conventional immunofluorescence assay. The ACIF assay often detected low levels of HTLV-III antigens within 3 days of infection in vitro, compared with 5 to 7 days with the indirect immunofluorescence assay, and generally paralleled the reverse transcriptase assay. The ACIF assay is a simple, sensitive, and specific assay for detection of HTLV-III-related antigens and antibodies. It should prove useful in the diagnosis of HTLV-III infection, as well as in studies of pathogenesis.

Published
1986
Full Text
View/download PDF

48. Synergistic inhibition of human immunodeficiency virus in vitro by azidothymidine and recombinant alpha A interferon

Author

Hartshorn, K L, Vogt, M W, Chou, T C, Blumberg, R S, Byington, R, Schooley, R T, and Hirsch, M S

Abstract

Both recombinant alpha A interferon and azidothymidine inhibit the replication of human immunodeficiency virus in peripheral blood mononuclear cells. Combinations of recombinant alpha A interferon and azidothymidine at concentrations that are easily achievable in patients synergistically inhibit human immunodeficiency virus in vitro with minimal toxicity. Combinations of antiretroviral compounds that act by different mechanisms may prove useful in the treatment of acquired immunodeficiency syndrome-related disorders.

Published
1987
Full Text
View/download PDF

49. Assessment of angina pectoris after myocardial infarction: comparison of "Rose Questionnaire" with physician judgment in the Beta-Blocker Heart Attack Trial.

Author

Friedman, L M and Byington, R P

Abstract

The London School of Hygiene Cardiovascular Questionnaire (Rose Questionnaire) was compared with physician opinion in assessment of angina pectoris in the Beta-Blocker Heart Attack Trial, a long-term (June 1978-October 1981), multicenter study of 3,837 post-myocardial infarction patients, half of whom were treated with propranolol and half with placebo. At baseline, about three times as many patients were thought to have angina by the physician as were diagnosed by the Questionnaire (36.1% vs. 11.5%). Over the average 25-month follow-up period, angina was identified by the physician 50% more often than by the Questionnaire (60.3% vs. 38.6%). The results for each treatment group (propranolol or placebo) were very similar to these overall results. Associations between diagnosis of angina and other patient characteristics were similar for the two measures at baseline. Although the physician diagnosis of angina identified more patients who suffered a subsequent fatal or nonfatal event than did the Questionnaire, it also diagnosed more angina patients who did not have an event. Thus, each of the measures of angina predicted total mortality and coronary heart disease mortality to similar extents (comparable relative risks), even after adjustment for covariates. Neither measure was significantly predictive of recurrent nonfatal myocardial infarction. One measure is not clearly superior to the other in this population. Other factors, such as cost and type of personnel available to conduct the study, may determine which measure is preferred.

Published
1985
Full Text
View/download PDF

50. Assessment of the association between habitual salt intake and high blood pressure: methodological problems.

Author

Liu, K, Cooper, R, McKeever, J, McKeever, P, Byington, R, Soltero, I, Stamler, R, Gosch, F, Stevens, E, and Stamler, J

Abstract

Despite the finding in cross-cultural comparisons that habitual sodium intake correlates with levels of blood pressure, similar studies from within population groups have yielded inconsistent results. The data presented in this report indicate that in industrialized societies the high degree of intra-individual variability of sodium intake, compared to much smaller inter-individual differences, may obscure potential biological correlations. A quantitative statistical method is presented to assess and minimize the effect of the large intra-individual variation in daily urinary sodium excretion.

Published
1979
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results