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Lipoprotein-Associa...
Lipoprotein-Associated Phospholipase A(2) Activity Is a Marker of Risk But Not a Useful Target for Treatment in Patients With Stable Coronary Heart Disease
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- Wallentin, Lars (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Held, Claes (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Armstrong, Paul W. (author)
- Univ Alberta, Canadian VIGOUR Ctr, Edmonton, AB, Canada.
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- Cannon, Christopher P. (author)
- Brigham & Womens Hosp, Div Cardiovasc, 75 Francis St, Boston, MA 02115 USA.;Harvard Clin Res Inst, Boston, MA USA.
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- Davies, Richard Y. (author)
- GlaxoSmithKline, Metab Pathways & Cardiovasc Therapeut Area, King Of Prussia, PA USA.
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- Granger, Christopher B. (author)
- Duke Univ, Med Ctr, Durham, NC USA.
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- Hagström, Emil (author)
- Uppsala universitet,Kardiologi
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- Harrington, Robert A. (author)
- Stanford Univ, Dept Med, Stanford, CA 94305 USA.
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- Hochman, Judith S. (author)
- NYU, Langone Med Ctr, Dept Med, New York, NY USA.
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- Koenig, Wolfgang (author)
- Univ Ulm, Med Ctr, Dept Internal Med Cardiol 2, Ulm, Germany.;Tech Univ Munich, Deutsch Herzzentrum Munchen, Munich, Germany.;DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany.
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- Krug-Gourley, Sue (author)
- GlaxoSmithKline, Metab Pathways & Cardiovasc Therapeut Area, King Of Prussia, PA USA.
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- Mohler, Emile R., III (author)
- Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA.
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- Siegbahn, Agneta (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)
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- Tarka, Elizabeth (author)
- GlaxoSmithKline, Former Employee Metab Pathways & Cardiovasc Thera, King Of Prussia, PA USA.
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- Steg, Philippe Gabriel (author)
- FACT, Paris, France.;Univ Paris Diderot, Sorbonne Paris Cite, DHU FIRE, Paris, France.;Hop Bichat Claude Bernard, INSERUM, U 1148, Paris, France.;Imperial Coll, Royal Brompton Hosp, ICMS, NHLI, London, England.
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- Stewart, Ralph A. H. (author)
- Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand.;Univ Auckland, Auckland 1, New Zealand.
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- Weiss, Robert (author)
- Maine Res Associates, Auburn, ME USA.
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- östlund, Ollie (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- White, Harvey D. (author)
- Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand.;Univ Auckland, Auckland 1, New Zealand.
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(creator_code:org_t)
- 2016
- 2016
- English.
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In: Journal of the American Heart Association. - 2047-9980. ; 5:6
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background - We evaluated lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) activity in patients with stable coronary heart disease before and during treatment with darapladib, a selective Lp-PLA(2) inhibitor, in relation to outcomes and the effects of darapladib in the STABILITY trial.Methods and Results - Plasma Lp-PLA(2) activity was determined at baseline (n=14 500); at 1 month (n=13 709); serially (n=100) at 3, 6, and 18 months; and at the end of treatment. Adjusted Cox regression models evaluated associations between Lp-PLA(2) activity levels and outcomes. At baseline, the median Lp-PLA(2) level was 172.4 mu mol/min per liter (interquartile range 143.1-204.2 mu mol/min per liter). Comparing the highest and lowest Lp-PLA(2) quartile groups, the hazard ratios were 1.50 (95% CI 1.23-1.82) for the primary composite end point (cardiovascular death, myocardial infarction, or stroke), 1.95 (95% CI 1.29-2.93) for hospitalization for heart failure, 1.42 (1.07-1.89) for cardiovascular death, and 1.37 (1.03-1.81) for myocardial infarction after adjustment for baseline characteristics, standard laboratory variables, and other prognostic biomarkers. Treatment with darapladib led to a approximate to 65% persistent reduction in median Lp-PLA(2) activity. There were no associations between on-treatment Lp-PLA(2) activity or changes of Lp-PLA(2) activity and outcomes, and there were no significant interactions between baseline and on-treatment Lp-PLA(2) activity or changes in Lp-PLA(2) activity levels and the effects of darapladib on outcomes.Conclusions - Although high Lp-PLA(2) activity was associated with increased risk of cardiovascular events, pharmacological lowering of Lp-PLA(2) activity by approximate to 65% did not significantly reduce cardiovascular events in patients with stable coronary heart disease, regardless of the baseline level or the magnitude of change of Lp-PLA(2) activity.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- atherosclerosis
- coronary disease
- inflammation
- lipoprotein
- myocardial infarction
Publication and Content Type
- ref (subject category)
- art (subject category)
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Wallentin, Lars
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Held, Claes
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Armstrong, Paul ...
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Cannon, Christop ...
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Davies, Richard ...
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Granger, Christo ...
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Hagström, Emil
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Harrington, Robe ...
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Hochman, Judith ...
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Koenig, Wolfgang
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Krug-Gourley, Su ...
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Mohler, Emile R. ...
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Siegbahn, Agneta
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Tarka, Elizabeth
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Steg, Philippe G ...
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Stewart, Ralph A ...
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Weiss, Robert
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östlund, Ollie
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White, Harvey D.
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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Uppsala University