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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Effect of torcetrapib on carotid atherosclerosis in familial hypercholesterolemia
New England Journal of Medicine, Volume 356, No. 16, Year 2007
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Description
Background: Torcetrapib, an inhibitor of cholesteryl ester transfer protein, may reduce atherosclerotic vascular disease by increasing levels of high-density lipoprotein (HDL) cholesterol. Methods: A total of 850 patients with heterozygous familial hypercholesterolemia underwent B-mode ultrasonography at baseline and at follow-up to measure changes in carotid intima-media thickness. The patients completed an atorvastatin run-in period and were subsequently randomly assigned to receive either atorvastatin monotherapy or atorvastatin combined with 60 mg of torcetrapib for 2 years. Results: After 24 months, in the atorvastatin-only group, the mean (±SD) HDL cholesterol level was 52.4±13.5 mg per deciliter and the mean low-density lipoprotein (LDL) cholesterol level was 143.2±42.2 mg per deciliter, as compared with 81.5±22.6 mg per deciliter and 115.1±48.5 mg per deciliter, respectively, in the torcetrapib-atorvastatin group. During the study, average systolic blood pressure increased by 2.8 mm Hg in the torcetrapib-atorvastatin group, as compared with the atorvastatin-only group. The increase in maximum carotid intima-media thickness, the primary measure of efficacy, was 0.0053±0.0028 mm per year in the atorvastatin-only group and 0.0047±0.0028 mm per year in the torcetrapib-atorvastatin group (P=0.87). The secondary efficacy measure, annualized change in mean carotid intima-media thickness for the common carotid artery, indicated a decrease of 0.0014 mm per year in the atorvastatin-only group, as compared with an increase of 0.0038 mm per year in the torcetrapib-atorvastatin group (P=0.005). Conclusions: In patients with familial hypercholesterolemia, the use of torcetrapib with atorvastatin, as compared with atorvastatin alone, did not result in further reduction of progression of atherosclerosis, as assessed by a combined measure of carotid arterial-wall thickness, and was associated with progression of disease in the common carotid segment. These effects occurred despite a large increase in HDL cholesterol levels and a substantial decrease in levels of LDL cholesterol and triglycerides. Copyright © 2007 Massachusetts Medical Society.
Authors & Co-Authors
Kastelein, Johannes Jacob Pieter
Netherlands, Amsterdam
Universiteit Van Amsterdam
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Van Leuven, Sander I.
Netherlands, Amsterdam
Universiteit Van Amsterdam
Burgess, Leslie
South Africa, Tygerberg
Tygerberg Hospital
Evans, Gregory W.
United States, Winston Salem
Wake Forest University
Kuivenhoven, Jan A.
Netherlands, Amsterdam
Universiteit Van Amsterdam
Barter, Philip J.
Australia, Sydney
Heart Research Institute Australia
Revkin, James H.
United States, New York
Pfizer Inc.
Grobbee, Diederick E Egbertus
Netherlands, Utrecht
University Medical Center Utrecht
Riley, Ward A.
United States, Winston Salem
Wake Forest University
Shear, Charles L.
United States, New York
Pfizer Inc.
Duggan, William T.
United States, New York
Pfizer Inc.
Bots, Michiel L.
Netherlands, Utrecht
University Medical Center Utrecht
Statistics
Citations: 585
Authors: 12
Affiliations: 7
Identifiers
Doi:
10.1056/NEJMoa071359
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Genetics And Genomics
Noncommunicable Diseases
Study Design
Cohort Study