41. Biologie Section 15 : Results – SerumCreatinineLevels Over Time SinceRandomization Mean (+ confidence interval ) serumlevels of creatinine (mg/dl) atbaseline and annualythereafter in the fenofibrate (red) and placebo (blue) groups
66. Résultat final (JACC 2010) Table 3 : Change From Baseline CIMT by Treatment Group for CompletingSubjects And for All SubjectsWith the Last Observation CarriedForward
67. Résultat final (JACC 2010) Figure 1 : Relationship BetweenQuarties of Cumulative Drug Exposure to Ezetimibe And Niacin and Change in CIMT Cumulative drugexposurewascalculated as the product of meanstudydrugadherence, close and time in the study . The relationshipbetween ( lowest, quartile 1, to highest, quartile 4) and change in meancarotidintima-mediathickness (CIMT) for all subjectsusing the method of last observation carried. Forwardisshown. The relationshipbetween quartiles of cumulative drugexposure and charge in CIMT isshownseparately for ezetimibe (blue line) (analysis of variance (ANOVA) p = 0.05) and niacin (red line) (ANOVA p = 0.23)
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71. AHA 2009, CHICAGO L’actualité 2010 en cardiologie Les grandes études de prévention DIEVART François Clinique Villette, Dunkerque
77. Reverse cholesterol transport and HDL metabolism CE= cholesterol ester; FC= free cholesterol; A-1= apolipoproteinA-1; ABC1= ATP-binding cassettte protein-1; LCAT= Lecithin:cholesterol acyl transeferase; SR-B1=scavenger receptor class B1
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79. HDL LDL / VLDL Liver Bile CE LDL-R FC FC LCAT CETP CE SR-B1 Free Cholesterol (FC) in Extrahepatic tissues CETP La Cholesteryl ester transfer protein (CETP) est une protéine plasmatique qui catalyse le transfert du cholestérol estérifié depuis les HDL jusqu’au apo-B (VLLD et LDL) en échange des triglycérides. X inhibition
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81. Étude ILLUMINATE: pronostic à long termes de coronariens ou équivalents coronariens
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84. DEFINE Safety of Anacetrapib in Patients with or at Risk for Coronary Heart Disease Christopher P. Cannon, MD, Sukrut Shah, PhD, RPh, Hayes M. Dansky, MD, Michael Davidson, MD, Eliot A. Brinton, MD, Antonio M. Gotto, Jr., MD, DPhil, Michael Stepanavage, MS, Sherry Xueyu Liu, MS, Patrice Gibbons, MS, Tanya B. Ashraf, BA, Jennifer Zafarino, MS, Yale Mitchel, MD, Philip Barter, MD, PhD, for the DEFINE Investigators D etermining the EF ficacy and Tolerability of CETP IN hibitionwithAnac E trapib
105. ACCORD PA : Paramètres évalués à la dernière visite
106. ACCORD PA : Résultats sur les critères primaires et secondaires Also examined Fatal/Nonfatal HF (HR=0.94, p=0.67), a composite of fatal coronary events, nonfatal MI and unstable angina (HR=0.94, p=0.50) and a composite of the primary outcome, revascularization and unstable angina (HR=0.95, p=0.40)
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111. ACCORD PA en résumé Diapositives supplémentaires
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114. ACCORD PA : Caractéristiques à l’inclusion * Median Value
Cholesteryl ester transfer protein (CETP) is a plasma protein that catalyzes the transfer of CE from HDL to apoB-containing lipoproteins (VLDL and LDL-C)in exchange for triglycerides that are transferred in the reverse direction. CETP inhibitors increase HDL-C and some also lower LDL-C, and therefore have the potential to reduce coronary events. HDL picks up free cholesterol (FC) from extrahepatic tissues. HDL FC is subsequently esterified by LCAT to form cholesteryl esters (CE) The HDL CE may then be delivered to the liver by either of two pathways: 1. A direct pathway following binding of HDL to hepatic SR-B1 2. An indirect pathway involving the CETP-mediated transfer of CE from HDL to VLDL and LDL with subsequent delivery to the liver following binding of LDL to the LDL receptor." After click: Inhibition of CETP prevents the transfer of CE from HDL to the VLDL/LDL fractions and results in an increase in concentration of HDL-C and a decrease in the cholesterol content of the VLDL/LDL.
ILLUMINATE is a multicenter, double-blind, parallel-group, clinical end point trial that is being conducted at 250 sites in 7 countries. Approximately 13,000 subjects with CHD or CHD risk equivalent will be randomized to treatment without regard to their baseline HDL-C levels. The primary end point is a composite of CHD death, nonfatal MI, or stroke. The study population includes men and women, 45 to 75 years of age, who have a prior history of CHD or a CHD risk equivalent and who are eligible for statin treatment. Baseline HDL-C level is not a feature of the inclusion or exclusion criteria. Subjects initially enter an atorvastatin run-in period during which atorvastatin treatment is initiated. Subjects previously treated with other statins are switched to an equivalent dose of atorvastatin. The atorvastatin dose is then titrated to a target LDL-C level of <100 mg/dL (2.6 mmol/L). Following attainment of the LDL-C goal, patients are randomized to either torcetrapib/atorvastatin or atorvastatin alone. In both treatment arms, the dose of atorvastatin is that established during the atorvastatin run-in phase. Follow-up is driven by end points (984 events) and estimated to last approximately 4.5 years. The primary end point is a composite of CHD death, nonfatal MI, or stroke.