Literature DB >> 20934559

Study design and rationale for the clinical outcomes of the STABILITY Trial (STabilization of Atherosclerotic plaque By Initiation of darapLadIb TherapY) comparing darapladib versus placebo in patients with coronary heart disease.

Harvey White1, Claes Held, Ralph Stewart, David Watson, Robert Harrington, Andrzej Budaj, Ph Gabriel Steg, Christopher P Cannon, Susan Krug-Gourley, Janet Wittes, Trupti Trivedi, Elizabeth Tarka, Lars Wallentin.   

Abstract

BACKGROUND: Elevated plasma levels of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) are associated with increased risk of cardiovascular (CV) events. Direct inhibition of this proinflammatory enzyme with darapladib may benefit CV patients when given as an adjunct to standard of care, including lipid-lowering and antiplatelet therapies.
METHODS: STABILITY is a randomized, placebo-controlled, double-blind, international, multicenter, event-driven trial. The study has randomized 15,828 patients with chronic coronary heart disease (CHD) receiving standard of care to darapladib enteric-coated (EC) tablets, 160 mg or placebo.
RESULTS: The primary end point is the composite of major adverse cardiovascular events (MACE): CV death, nonfatal myocardial infarction, and nonfatal stroke. The key secondary end points will include major coronary events, total coronary events, individual components of MACE, and all-cause mortality. Prespecified substudies include 24-hour ambulatory blood pressure monitoring, albuminuria progression, changes in cognitive function, and pharmacokinetic and biomarker analyses. Health economic outcomes and characterization of baseline lifestyle risk factors also will be assessed. The study will continue until 1,500 primary end points have occurred to achieve 90% power to detect a 15.5% reduction in the primary end point. The median treatment duration is anticipated to be 2.75 years.
CONCLUSIONS: STABILITY will assess whether direct inhibition of Lp-PLA(2) with darapladib added to the standard of care confers clinical benefit to patients with CHD.
Copyright © 2010 Mosby, Inc. All rights reserved.

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Year:  2010        PMID: 20934559     DOI: 10.1016/j.ahj.2010.07.006

Source DB:  PubMed          Journal:  Am Heart J        ISSN: 0002-8703            Impact factor:   4.749


  42 in total

Review 1.  Modulation of oxidative stress, inflammation, and atherosclerosis by lipoprotein-associated phospholipase A2.

Authors:  Robert S Rosenson; Diana M Stafforini
Journal:  J Lipid Res       Date:  2012-06-04       Impact factor: 5.922

2.  Eight genetic loci associated with variation in lipoprotein-associated phospholipase A2 mass and activity and coronary heart disease: meta-analysis of genome-wide association studies from five community-based studies.

Authors:  Harald Grallert; Josée Dupuis; Joshua C Bis; Abbas Dehghan; Maja Barbalic; Jens Baumert; Chen Lu; Nicholas L Smith; André G Uitterlinden; Robert Roberts; Natalie Khuseyinova; Renate B Schnabel; Kenneth M Rice; Fernando Rivadeneira; Ron C Hoogeveen; João Daniel Fontes; Christa Meisinger; John F Keaney; Rozenn Lemaitre; Yurii S Aulchenko; Ramachandran S Vasan; Stephen Ellis; Stanley L Hazen; Cornelia M van Duijn; Jeanenne J Nelson; Winfried März; Heribert Schunkert; Ruth M McPherson; Heide A Stirnadel-Farrant; Bruce M Psaty; Christian Gieger; David Siscovick; Albert Hofman; Thomas Illig; Mary Cushman; Jennifer F Yamamoto; Jerome I Rotter; Martin G Larson; Alexandre F R Stewart; Eric Boerwinkle; Jacqueline C M Witteman; Russell P Tracy; Wolfgang Koenig; Emelia J Benjamin; Christie M Ballantyne
Journal:  Eur Heart J       Date:  2011-10-14       Impact factor: 29.983

Review 3.  Lipid parameters for measuring risk of cardiovascular disease.

Authors:  Benoit J Arsenault; S Matthijs Boekholdt; John J P Kastelein
Journal:  Nat Rev Cardiol       Date:  2011-02-01       Impact factor: 32.419

Review 4.  The role of intravascular ultrasound in the determination of progression and regression of coronary artery disease.

Authors:  Hideaki Kaneda; Mitsuyasu Terashima; Hiroshi Yamaguchi
Journal:  Curr Atheroscler Rep       Date:  2012-04       Impact factor: 5.113

Review 5.  Targeting inflammation: impact on atherothrombosis.

Authors:  Maria Giulia Marini; Chiara Sonnino; Marco Previtero; Luigi M Biasucci
Journal:  J Cardiovasc Transl Res       Date:  2013-12-11       Impact factor: 4.132

Review 6.  Immune effector mechanisms implicated in atherosclerosis: from mice to humans.

Authors:  Peter Libby; Andrew H Lichtman; Göran K Hansson
Journal:  Immunity       Date:  2013-06-27       Impact factor: 31.745

Review 7.  Platelet activating factor in heart failure: potential role in disease progression and novel target for therapy.

Authors:  Paraskevi Detopoulou; Tzortzis Nomikos; Elizabeth Fragopoulou; Christina Chrysohoou; Smaragdi Antonopoulou
Journal:  Curr Heart Fail Rep       Date:  2013-06

8.  Therapeutic Options to Reduce Lp-PLA2 Levels and the Potential Impact on Vascular Risk Reduction.

Authors:  Koto Ishida; Brett Cucchiara
Journal:  Curr Treat Options Cardiovasc Med       Date:  2013-06

Review 9.  Medical management of stable coronary atherosclerosis.

Authors:  P Pellicori; P Costanzo; A C Joseph; A Hoye; S L Atkin; J G F Cleland
Journal:  Curr Atheroscler Rep       Date:  2013-04       Impact factor: 5.113

10.  Oxidatively modified phosphatidylserines on the surface of apoptotic cells are essential phagocytic 'eat-me' signals: cleavage and inhibition of phagocytosis by Lp-PLA2.

Authors:  V A Tyurin; K Balasubramanian; D Winnica; Y Y Tyurina; A S Vikulina; R R He; A A Kapralov; C H Macphee; V E Kagan
Journal:  Cell Death Differ       Date:  2014-01-24       Impact factor: 15.828

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