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1. Effects of statin therapy on diagnoses of new-onset diabetes and worsening glycaemia in large-scale randomised blinded statin trials: an individual participant data meta-analysis

Author

Reith, Christina, Preiss, David, Blackwell, Lisa, Emberson, Jonathan, Spata, Enti, Davies, Kelly, Halls, Heather, Harper, Charlie, Holland, Lisa, Wilson, Kate, Roddick, Alistair J, Cannon, Christopher P, Clarke, Robert, Colhoun, Helen M, Durrington, Paul N, Goto, Shinya, Hitman, Graham A, Hovingh, G Kees, Jukema, J Wouter, Koenig, Wolfgang, Marschner, Ian, Mihaylova, Borislava, Newman, Connie, Probsfield, Jeffrey L, Ridker, Paul M, Sabatine, Marc S, Sattar, Naveed, Schwartz, Gregory G, Tavazzi, Luigi, Tonkin, Andrew, Trompet, Stella, White, Harvey, Yusuf, Salim, Armitage, Jane, Keech, Anthony, Simes, John, Collins, Rory, Baigent, Colin, Barnes, Elizabeth, Fulcher, Jordan, Herrington, William G, Kirby, Adrienne, O'Connell, Rachel, Amarenco, Pierre, Arashi, Hiroyuki, Barter, Philip, Betteridge, D John, Blazing, Michael, Blauw, Gerard J, Bosch, Jackie, Bowman, Louise, Braunwald, Eugene, Bulbulia, Richard, Byington, Robert, Clearfield, Michael, Cobbe, Stuart, Dahlöf, Björn, Davis, Barry, de Lemos, James, Downs, John R, Fellström, Bengt, Flather, Marcus, Ford, Ian, Franzosi, Maria Grazia, Fuller, John, Furberg, Curt, Glynn, Robert, Goldbourt, Uri, Gordon, David, Gotto, Jr, Antonio, Grimm, Richard, Gupta, Ajay, Hawkins, C Morton, Haynes, Richard, Holdaas, Hallvard, Hopewell, Jemma, Jardine, Alan, Kastelein, John JP, Kean, Sharon, Kearney, Patricia, Kitas, George, Kjekshus, John, Knatterud, Genell, Knopp, Robert H, Koren, Michael, Krane, Vera, Landray, Martin, LaRosa, John, Latini, Roberto, Lonn, Eva, Lucci, Donata, MacFadyen, Jean, Macfarlane, Peter, MacMahon, Stephen, Maggioni, Aldo, Marchioli, Roberto, Moyé, Lemuel, Murphy, Sabina, Neil, Andrew, Nicolis, Enrico B, Packard, Chris, Parish, Sarah, Pedersen, Terje R, Peto, Richard, Pfeffer, Marc, Poulter, Neil, Pressel, Sara, Probstfield, Jeffrey, Rahman, Mahboob, Robertson, Michele, Sacks, Frank, Schmieder, Roland, Serruys, Patrick, Sever, Peter, Shaw, John, Shepherd, James, Simpson, Lara, Sleight, Peter, Smeeth, Liam, Tobert, Jonathan, Tognoni, Gianni, Varigos, John, Wanner, Christoph, Wedel, Hans, Weis, Stephen, Welch, K Michael, Wikstrand, John, Wilhelmsen, Lars, Wiviott, Stephen, Yamaguchi, Junichi, Young, Robin, and Zannad, Faiez

Published
2024
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2. Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials

Author

Reith, Christina, Baigent, Colin, Blackwell, Lisa, Emberson, Jonathan, Spata, Enti, Davies, Kelly, Halls, Heather, Holland, Lisa, Wilson, Kate, Armitage, Jane, Harper, Charlie, Preiss, David, Roddick, Alistair, Keech, Anthony, Simes, John, Collins, Rory, Barnes, Elizabeth, Fulcher, Jordan, Herrington, William G, Kirby, Adrienne, Mihaylova, Borislava, O'Connell, Rachel, Amarenco, Pierre, Barter, Philip, Betteridge (deceased), D John, Blazing, Michael, Bosch, Jackie, Bowman, Louise, Braunwald, Eugene, Cannon, Christopher P, Clearfield, Michael, Cobbe, Stuart, Colhoun, Helen M, Dahlöf, Björn, Davis, Barry, de Lemos, James, Downs, John R, Durrington, Paul N, Fellström, Bengt, Ford, Ian, Franzosi, Maria Grazia, Fuller (deceased), John, Furberg, Curt, Glynn, Robert, Gordon, David, Gotto Jr, Antonio, Grimm, Richard, Gupta, Ajay, Hawkins, C Morton, Hitman, Graham A, Holdaas (deceased), Hallvard, Jardine, Alan, Jukema, J Wouter, Kastelein, John JP, Kean, Sharon, Kjekshus, John, Knatterud (deceased), Genell, Knopp (deceased), Robert H, Koenig, Wolfgang, Koren, Michael, Krane, Vera, Landray, Martin, LaRosa, John, Latini, Roberto, Lonn, Eva, Lucci, Donata, MacFadyen, Jean, Macfarlane, Peter, MacMahon, Stephen, Maggioni, Aldo, Marchioli, Roberto, Marschner, Ian, Moyé, Lemuel, Murphy, Sabina, Neil, Andrew, Nicolis, Enrico B, Packard, Chris, Parish, Sarah, Pedersen, Terje R, Peto, Richard, Pfeffer, Marc, Poulter, Neil, Pressel, Sara, Probstfield, Jeffrey, Rahman, Mahboob, Ridker, Paul M, Robertson, Michele, Sacks, Frank, Sattar, Naveed, Schmieder, Roland, Serruys, Patrick W, Sever, Peter, Shaw (deceased), John, Shepherd (deceased), James, Simpson, Lara, Sleight (deceased), Peter, Tavazzi, Luigi, Tognoni, Gianni, Tonkin, Andrew, Trompet, Stella, Wanner, Christoph, Wedel, Hans, Weis, Stephen, Welch, K Michael, White, Harvey, Wikstrand, John, Wilhelmsen, Lars, Wiviott, Stephen, Young, Robin, Yusuf, Salim, Zannad, Faiez, Arashi, Hiroyuki, Byington, Robert, Clarke, Robert, Flather, Marcus, Goldbourt, Uri, Goto, Shinya, Hopewell, Jemma, Hovingh, Kees, Kearney, Patricia, Kitas, George, Newman, Connie, Sabatine, Marc S, Schwartz, Greg, Smeeth, Liam, Tobert, Jonathan, Varigos, John, and Yamaguchi, Junichi

Published
2022
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3. Isoprenaline increases Excursive Restitution Slope in the Conscious Rabbit with Ischaemic Heart Failure

Author

Kimotsuki, Tomofumi, Niwa, Noriko, Hicks, Martin N., Dunne, Michael, Cobbe, Stuart M., and Watanabe, Mari A.

Subjects
Quantitative Biology - Tissues and Organs
Abstract

Background: An increased QT/RR slope is hypothesized to be predictive of sudden cardiac death after myocardial infarction. Previous studies have shown that beta-adrenergic stimulation increases QT/RR slope, but the effects of beta-adrenergic stimulation on QT/RR slope in heart failure are unknown. Methods: New Zealand White rabbits underwent coronary ligation (n=15) or sham surgery (n=11), and implantation of a pediatric pacemaker lead in the right ventricle for chronic ECG recording. Eight weeks after surgery, unsedated rabbits were given intravenous administrations of 0.25 to 2.0 ml of 1 micromol/l isoprenaline, while peak QRS to QRS (RR) and Q to T peak (QT) intervals were measured. Results: Ligated rabbits (n=6) had lower LVEF than sham rabbits (n=7, p<.0001), but similar baseline RR (269 +/- 15 vs 292 +/- 23 ms, p=.07), QT (104 +/- 17 vs 91 +/- 9 ms, p=.1) and minimum RR (204 +/- 11 vs 208 +/- 6 ms, p=.4) intervals induced by isoprenaline (0.79 +/- 0.18 vs 0.73 +/- 0.14 ml, p=.6). Hysteresis in QT vs TQ interval plots displayed biphasic restitution and regions of negative slope. The slope of the positive slope region was >1 in ligated rabbits (1.27 +/- 0.66) and <1 in sham rabbits (0.35 +/- 0.14, p=.004). Absolute value of the negative slope was greater in ligated rabbits (-0.81 +/- 0.52 vs -0.35 +/- 0.14, p=.04). Conclusion: Ischaemic heart failure produces steeper restitution slopes during beta-adrenergically induced QT/TQ hysteresis. This could underlie the propensity of failing hearts to arrhythmias., Comment: 27 pages

Published
2009

5. The Prevention of Progression of Arterial Disease and Diabetes (POPADAD) Trial: Factorial Randomised Placebo Controlled Trial of Aspirin and Antioxidants in Patients with Diabetes and Asymptomatic Peripheral Arterial Disease

Author

Belch, Jill, MacCuish, Angus, Campbell, Iain, Cobbe, Stuart, Taylor, Roy, Prescott, Robin, Lee, Robert, Bancroft, Jean, MacEwan, Shirley, Shepherd, James, Macfarlane, Peter, Morris, Andrew, Jung, Roland, Kelly, Christopher, Connacher, Alan, Peden, Norman, Jamieson, Andrew, Mathews, David, Leese, Graeme, McKnight, John, O'Brien, Iain, Semple, Colin, Petrie, John, Gordon, Derek, Pringle, Stuart, and MacWalter, Ron

Published
2008

8. Public Access Defibrillators

Author

Woollard, Malcolm F., Colquhoun, Michael C., Pell, Jill P., Sirel, Jane M., Walker, Nicola L., Cobbe, Stuart M., Marsden, Andrew K., Ford, Ian, Chaloner, Judith, Gent, Nick, Espinosa-Brito, Alfredo D., Espinosa-Roca, Alfredo A., Quintero-Méndez, Yenisey, and Cutiño-Maás, Yainel

Published
2003

17. Effect of activation sequence on transmural patterns of repolarization and action potential duration in rabbit ventricular myocardium

Author

Myles, Rachel C., Bernus, Olivier, Burton, Francis L., Cobbe, Stuart M., and Smith, Godfrey L.

Subjects
Action potentials (Electrophysiology) -- Models, Heart ventricles -- Electric properties, Electrophysiology -- Research, Biological sciences
Abstract

Although transmural heterogeneity of action potential duration (APD) is established in single cells isolated from different tissue layers, the extent to which it produces transmural gradients of repolarization in electrotonically coupled ventricular myocardium remains controversial. The purpose of this study was to examine the relative contribution of intrinsic cellular gradients of APD and electrotonic influences to transmural repolarization in rabbit ventricular myocardium. Transmural optical mapping was performed in left ventricular wedge preparations from eight rabbits. Transmural patterns of activation, repolarization, and APD were recorded during endocardial and epicardial stimulation. Experimental results were compared with modeled data during variations in electrotonic coupling. A transmural gradient of APD was evident during endocardial stimulation, which reflected differences previously seen in isolated cells, with the longest APD at the endocardium and the shortest at the epicardium (endo: 165 [+ or -] 5 vs. epi: 147 [+ or -] 4 ms; P < 0.05). During epicardial stimulation, this gradient reversed (epi: 162 [+ or -] 4 vs. endo: 148 [+ or -] 6 ms; P < 0.05). In both activation sequences, transmural repolarization followed activation and APD shortened along the activation path such that significant transmural gradients of repolarization did not occur. This correlation between transmural activation time and APD was recapitulated in simulations and varied with changes in intercellular coupling, confirming that it is mediated by electrotonic current flow between cells. These data suggest that electrotonic influences are important in determining the transmural repolarization sequence in rabbit ventricular myocardium and that they are sufficient to overcome intrinsic differences in the electrophysiological properties of the cells across the ventricular wall. action potential remodeling; electrophysiology doi: 10.1152/ajpheart.00518.2010.

Published
2010

18. Assessing Risk Prediction Models Using Individual Participant Data From Multiple Studies

Author

Pennells, Lisa, Kaptoge, Stephen, White, Ian R., Thompson, Simon G., Wood, Angela M., Tipping, Robert W., Folsom, Aaron R., Couper, David J., Ballantyne, Christie M., Coresh, Josef, Goya Wannamethee, S., Morris, Richard W., Kiechl, Stefan, Willeit, Johann, Willeit, Peter, Schett, Georg, Ebrahim, Shah, Lawlor, Debbie A., Yarnell, John W., Gallacher, John, Cushman, Mary, Psaty, Bruce M., Tracy, Russ, Tybjærg-Hansen, Anne, Price, Jackie F., Lee, Amanda J., McLachlan, Stela, Khaw, Kay-Tee, Wareham, Nicholas J., Brenner, Hermann, Schöttker, Ben, Müller, Heiko, Jansson, Jan-Håkan, Wennberg, Patrik, Salomaa, Veikko, Harald, Kennet, Jousilahti, Pekka, Vartiainen, Erkki, Woodward, Mark, DʼAgostino, Ralph B., Bladbjerg, Else-Marie, Jørgensen, Torben, Kiyohara, Yutaka, Arima, Hisatomi, Doi, Yasufumi, Ninomiya, Toshiharu, Dekker, Jacqueline M., Nijpels, Giel, Stehouwer, Coen D. A., Kauhanen, Jussi, Salonen, Jukka T., Meade, Tom W., Cooper, Jackie A., Cushman, Mary, Folsom, Aaron R., Psaty, Bruce M., Shea, Steven, Döring, Angela, Kuller, Lewis H., Grandits, Greg, Gillum, Richard F., Mussolino, Michael, Rimm, Eric B., Hankinson, Sue E., Manson, JoAnn E., Pai, Jennifer K., Kirkland, Susan, Shaffer, Jonathan A., Shimbo, Daichi, Bakker, Stephan J. L., Gansevoort, Ron T., Hillege, Hans L., Amouyel, Philippe, Arveiler, Dominique, Evans, Alun, Ferrières, Jean, Sattar, Naveed, Westendorp, Rudi G., Buckley, Brendan M., Cantin, Bernard, Lamarche, Benoît, Barrett-Connor, Elizabeth, Wingard, Deborah L., Bettencourt, Richele, Gudnason, Vilmundur, Aspelund, Thor, Sigurdsson, Gunnar, Thorsson, Bolli, Kavousi, Maryam, Witteman, Jacqueline C., Hofman, Albert, Franco, Oscar H., Howard, Barbara V., Zhang, Ying, Best, Lyle, Umans, Jason G., Onat, Altan, Sundström, Johan, Michael Gaziano, J., Stampfer, Meir, Ridker, Paul M., Michael Gaziano, J., Ridker, Paul M., Marmot, Michael, Clarke, Robert, Collins, Rory, Fletcher, Astrid, Brunner, Eric, Shipley, Martin, Kivimäki, Mika, Ridker, Paul M., Buring, Julie, Cook, Nancy, Ford, Ian, Shepherd, James, Cobbe, Stuart M., Robertson, Michele, Walker, Matthew, Watson, Sarah, Alexander, Myriam, Butterworth, Adam S., Angelantonio, Emanuele Di, Gao, Pei, Haycock, Philip, Kaptoge, Stephen, Pennells, Lisa, Thompson, Simon G., Walker, Matthew, Watson, Sarah, White, Ian R., Wood, Angela M., Wormser, David, and Danesh, John

Published
2014
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20. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis

Author

Fellstrom, Bengt C., Holdaas, Hallvard, Jardine, Alan G., Schmieder, Roland E., Bannister, Kym, Beutler, Jaap, Chae, Dong-Wan, Cobbe, Stuart M., Gronhagen-Riska, Carola, De Lima, Jose J., Lins, Robert, Chevaile, Alejandro, Mayer, Gert, Parving, Hans-Henrik, Remuzzi, Giuseppe, Samuelsson, Ola, McMahon, Alan W., Sonkodi, Sandor, Tsakiris, Dimitrios, Tesar, Vladimir, Todorov, Vasil, Suleymanlar, Gultekin, Wiecek, Andrzej, Gottlow, Mattis, Johnsson, Eva, Zannad, Faiez, and Wuthrich, Rudolf P.

Subjects
Rosuvastatin -- Usage, Rosuvastatin -- Health aspects, Cardiovascular diseases -- Care and treatment, Mortality -- Prevention, Hemodialysis -- Usage
Abstract

The study aims to evaluate the efficacy of the use of statins like rosuvastatin in reducing cardiovascular events in patients undergoing hemodialysis. The results indicate that rosuvastatin did reduce the LDL cholesterol level among such patients but did not help prevent mortality from cardiovascular causes.

Published
2009

21. Smoke-free legislation and hospitalizations for acute coronary syndrome

Author

Pell, Jill P., Haw, Sally, Cobbe, Stuart, Newby, David E., Pell, Alastair C.H., Fischbacher, Colin, McConnachie, Alex, Pringle, Stuart, Murdoch, David, Dunn, Frank, Oldroyd, Keith, MacIntyre, Paul, O'Rourke, Brian, and Borland, William

Subjects
Market trend/market analysis, Government regulation, Coronary heart disease -- Care and treatment, Smoking cessation programs -- Laws, regulations and rules, Smoking cessation programs -- Health aspects, Hospitals -- Admission and discharge, Hospitals -- Forecasts and trends
Abstract

The study aims to establish a relationship between a decrease in the number of admission in hospitals for acute coronary syndrome and smoke-free legislations. The results conclude that admissions into hospitals for acute coronary syndrome decreased after implementation of smoke-free legislations.

Published
2008

22. Long-term follow-up of the West of Scotland coronary prevention study

Author

Ford, Ian, Shepherd, James, Murray, Heather, Packard, Chris J., Macfarlane, Peter W., and Cobbe, Stuart M.

Subjects
Coronary heart disease -- Prevention, Coronary heart disease -- Drug therapy, Pravastatin -- Health aspects
Abstract

A randomized clinical trial was conducted for comparing pravastatin with placebo in men having hypercholesterolemia, with a follow-up of five years to study coronary prevention. The results concluded that pravastatin led to a significant reduction in coronary events.

Published
2007

35. EHRA Expert Consensus Statement on the management of cardiovascular implantable electronic devices in patients nearing end of life or requesting withdrawal of therapy

Author

Padeletti, Luigi, Arnar, David O., Boncinelli, Lorenzo, Brachman, Johannes, Camm, John A., Daubert, Jean Claude, Kassam, Sarah, Deliens, Luc, Glikson, Michael, Hayes, David, Israel, Carsten, Lampert, Rachel, Lobban, Trudie, Raatikainen, Pekka, Siegal, Gil, Vardas, Panos, Kirchhof, Paulus, Becker, Rüdiger, Cosio, Francisco, Loh, Peter, Cobbe, Stuart, Grace, Andrew, and Morgan, John

Published
2010
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43. A Multicenter, Randomized, Placebo-Controlled Trial of Atorvastatin for the Primary Prevention of Cardiovascular Events in Patients With Rheumatoid Arthritis

Author

Kitas, George D, Nightingale, Peter, Armitage, Jane, Sattar, Naveed, Belch, Jill JF, Symmons, Deborah PM, Williams, Hawys, Vasishta, Shobna, Storey, Rebecca, Bruce, Ian, Durrington, Paul, McInnes, Iain, Situnayake, Deva, Struthers, Allan, Lowe, Gordon, Fox, Keith, Haskard, Dorian, Dore, Caroline, Bosworth, Ailsa, Frenneaux, Michael, Edwards, Christopher, Emberson, Jonathan, Bax, Deborah, Cobbe, Stuart, Stott, David, Sturrock, Roger, Macfarlane, Peter, Klocke, Rainer, Pullar, Tom, Tan, Su, Knight, Susan, Rowe, Iain, Kumar, Pradeep, Goodson, Nicky, Mulherin, Diarmuid, Brzeski, Micheal, Gardiner, Philip, Walker, David, Callaghan, Rob, Allen, Margaret, McCarey, David, George, Emmanuel, Deighton, Chris, Kirkham, Bruce, Teh, Lee-Suan, Luqmani, Raashid, Chakravarty, Kuntal, Roussou, Euthalia, Nixon, Jenny, Richards, Selwyn, Scott, David, Woolf, Tony, Prouse, Peter, Packham, Jonathan, Davies, Martin, DeLord, Denise, O'Neill, Terence, Pande, Ira, Watts, Richard, Rankin, Elizabeth, Papasawas, George, Emery, Paul, Morgan, Ann, Sinha, Arvind, Dasgupta, Bhaskar, Creamer, Paul, Zoma, Asad, Walsh, David, Van-Laar, Jaap, Capps, Nigel, Cairns, Andrew, Marguerie, Christopher, Kumar, Namita, Abernethy, Rikki, Lillicrap, Mark, Ralston, Stuart, Makadsi, Raad, Hopkinson, Neil, Akil, Mohammed, Ahmad, Yasmeen, Adler, Matthew, Bukhari, Marwan, Sanders, Paul, Binymin, Khalid, Hassan, Alaa, Hughes, Rod, Irani, Mike, O'Reilly, David, Sainsbury, Paul, Richmond, Ruth, Malgorzata, Magliano, Nisar, Mohammed, McEntergart, Ann, Roy, Dipak, Marks, Jeffrey, Batley, Michael, Mahmud, Taher, McKenna, Frank, Harris, Helen, Smyth, Anita, Tunn, Eddie, Young, Adam, Baburaj, Krishnan, Thomas, Joegi, Hall, Frances, Marshall, Tarnya, Rao, Chandini, Dixey, Josh, Gendi, Nagui, Birrell, Fraser, Chelliah, Gladstone, Fishman, Daniel, Knights, Sally, Coady, David, Smith, Bill, Harrison, Beverley, Naz, Sophia, Siebert, Stefan, Chan, Anthony, Putchakayala, Kiran, Al-Ansari, Atheer, Gough, Andrew, Pyne, Dev, Patel, Yusaf, Isdale, Amanda, Harvie, John, Consortium, TRACERA, Comm, Trial Management, Comm, Trial Steering, Comm, Data Monitoring, Comm, Endpoints, and Principal, TRACERA Recruiting Ctr

Published
2019

44. A multicenter, randomized, placebo‐controlled trial of atorvastatin for the primary prevention of cardiovascular events in patients with rheumatoid arthritis

Author

Kitas, George D., Nightingale, Peter, Armitage, Jane, Sattar, Naveed, Belch, Jill J. F., Symmons, Deborah P. M., Kitas, George, Belch, Jill, Symmons, Deborah, Williams, Hawys, Vasishta, Shobna, Storey, Rebecca, Bruce, Ian, Durrington, Paul, McInnes, Iain, Situnayake, Deva, Struthers, Allan, Lowe, Gordon, Fox, Keith, Haskard, Dorian, Dore, Caroline, Bosworth, Ailsa, Frenneaux, Michael, Edwards, Christopher, Emberson, Jonathan, Bax, Deborah, Cobbe, Stuart, Stott, David, Sturrock, Roger, Macfarlane, Peter, Klocke, Rainer, Pullar, Tom, Knight, Susan, Rowe, Iain, Kumar, Pradeep, Goodson, Nicky, Mulherin, Diarmuid, Brzeski, Micheal, Gardiner, Philip, Walker, David, Callaghan, Rob, Allen, Margaret, McCarey, David, George, Emmanuel, Deighton, Chris, Kirkham, Bruce, Teh, Lee‐Suan, Luqmani, Raashid, Chakravarty, Kuntal, Nixon, Jenny, Richards, Selwyn, Scott, David, Woolf, Tony, Prouse, Peter, Packham, Jonathan, Davies, Martin, DeLord, Denise, O’Neill, Terence, Pande, Ira, Harvie, John, Watts, Richard, Rankin, Elizabeth, Papasavvas, George, Emery, Paul, Sinha, Arvind, Dasgupta, Bhaskar, Creamer, Paul, Zoma, Asad, Walsh, David, Van‐Laar, Jaap, Capps, Nigel, Cairns, Andrew, Marguerie, Christopher, Kumar, Namita, Abernethy, Rikki, Lillicrap, Mark, Ralston, Stuart, Makadsi, Raad, Hopkinson, Neil, Tan, Su, Akil, Mohammed, Ahmad, Yasmeen, Adler, Matthew, Bukhari, Marwan, Sanders, Paul, Roussou, Euthalia, Binymin, Khalid, Hassan, Alaa, Hughes, Rod, O’Reilly, David, Sainsbury, Paul, Richmond, Ruth, Malgorzata, Magliano, Nisar, Mohammed, McEntergart, Ann, Roy, Dipak, Marks, Jeffrey, Batley, Michael, McKenna, Frank, Irani, Mike, Harris, Helen, Smyth, Anita, Tunn, Eddie, Young, Adam, Thomas, Joegi, Hall, Frances, Marshall, Tarnya, Rao, Chandini, Baburaj, Krishnan, Dixey, Josh, Gendi, Nagui, Birrell, Fraser, Chelliah, Gladstone, Morgan, Ann, Fishman, Daniel, Knights, Sally, Coady, David, Smith, Bill, Harrison, Beverley, Siebert, Stefan, Chan, Anthony, Putchakayala, Kiran, Al‐Ansari, Atheer, Gough, Andrew, Naz, Sophia, Pyne, Dev, Mahmud, Taher, Patel, Yusaf, and Isdale, Amanda

Abstract

Objective:\ud \ud Rheumatoid arthritis (RA) is associated with increased cardiovascular event (CVE) risk. The impact of statins in RA is not established. We assessed whether atorvastatin is superior to placebo for the primary prevention of CVEs in RA patients.\ud Methods:\ud \ud A randomized, double‐blind, placebo‐controlled trial was designed to detect a 32% CVE risk reduction based on an estimated 1.6% per annum event rate with 80% power at P < 0.05. RA patients age >50 years or with a disease duration of >10 years who did not have clinical atherosclerosis, diabetes, or myopathy received atorvastatin 40 mg daily or matching placebo. The primary end point was a composite of cardiovascular death, myocardial infarction, stroke, transient ischemic attack, or any arterial revascularization. Secondary and tertiary end points included plasma lipids and safety.\ud Results:\ud \ud A total of 3,002 patients (mean age 61 years; 74% female) were followed up for a median of 2.51 years (interquartile range [IQR] 1.90, 3.49 years) (7,827 patient‐years). The study was terminated early due to a lower than expected event rate (0.70% per annum). Of the 1,504 patients receiving atorvastatin, 24 (1.6%) experienced a primary end point, compared with 36 (2.4%) of the 1,498 receiving placebo (hazard ratio [HR] 0.66 [95% confidence interval (95% CI) 0.39, 1.11]; P = 0.115 and adjusted HR 0.60 [95% CI 0.32, 1.15]; P = 0.127). At trial end, patients receiving atorvastatin had a mean ± SD low‐density lipoprotein (LDL) cholesterol level 0.77 ± 0.04 mmoles/liter lower than those receiving placebo (P < 0.0001). C‐reactive protein level was also significantly lower in the atorvastatin group than the placebo group (median 2.59 mg/liter [IQR 0.94, 6.08] versus 3.60 mg/liter [IQR 1.47, 7.49]; P < 0.0001). CVE risk reduction per mmole/liter reduction in LDL cholesterol was 42% (95% CI −14%, 70%). The rates of adverse events in the atorvastatin group (n = 298 [19.8%]) and placebo group (n = 292 [19.5%]) were similar.\ud Conclusion:\ud \ud Atorvastatin 40 mg daily is safe and results in a significantly greater reduction of LDL cholesterol level than placebo in patients with RA. The 34% CVE risk reduction is consistent with the Cholesterol Treatment Trialists’ Collaboration meta‐analysis of statin effects in other populations.

Published
2019

45. Association Between Apolipoprotein E4 and Cognitive Decline in Elderly Adults

Author

Packard, Chris J., Westendorp, Rudi G.J., Stott, David J., Caslake, Muriel J., Murray, Heather M., Shepherd, James, Blauw, Gerard J., Murphy, Michael B., Bollen, Edward L.E.M., Buckley, Brendan M., Cobbe, Stuart M., Ford, Ian, Gaw, Allan, Hyland, Michael, Jukema, J. Wouter, Kamper, Adriaan M., Macfarlane, Peter W., Jolles, Jellemer, Perry, Ivan J., Sweeney, Brian J., and Twomey, Cillian

Published
2007

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