Comparison of the dose-response relationships of 2 lipid-lowering agents: a Bayesian meta-analysis.


BACKGROUND:Comparing the dose-response of a new drug to that of a previously studied drug can aid in understanding their relative potencies. Two dose-finding studies addressed the effect of a new drug, rosuvastatin, on its ability to decrease low-density lipoprotein cholesterol (LDL-C) levels. One of these studies included 2 doses of atorvastatin, and substantial additional information is available in the literature about the effect of atorvastatin on LDL-C level lowering. METHODS:The 2 dose-finding studies of rosuvastatin considered otherwise healthy patients who had hypercholesterolemia. Comparable studies of atorvastatin were identified via a MEDLINE search in December 1999. Multiple reviewer consensus identified 15 of 41 studies on atorvastatin published since 1996 that met these selection criteria: reporting of LDL-C level change from baseline at least 6 weeks after treatment initiation, doses administered, and treatment group sizes. Eligible populations had clinical evidence of hypercholesterolemia. We excluded studies with patients who had severe illness or a previous history of transplantation. Data extraction of the mean, sample sizes, and SDs (or CIs) by dose was carried out independently by multiple reviewers. We combined the results from the various studies with Bayesian hierarchical modeling and analyzed them with Markov chain Monte Carlo techniques. RESULTS:Combining this study and literature results substantially increased the power to compare the dose-response relationships of rosuvastatin and atorvastatin. Rosuvastatin reduced LDL-C level by an estimated 10 to 17 percentage points more than atorvastatin when both were given at the same dose. Approximately one quarter of the dose of rosuvastatin achieved about the same magnitude of LDL-C level reduction as atorvastatin at dosages as high as 80 mg. This finding does not imply a 4-fold difference in efficacy overall and specifically does not describe the results at higher dosage levels. CONCLUSIONS:Bayesian meta-analysis of results from related studies allows the comparison of the dose-response relationships of 2 drugs, better estimates of a particular dose-response relationship within an individual study, and the expression of relative benefits (of dose and drug) in terms of probabilities. Explicitly comparing a study's results with historical data using Bayesian meta-analysis allows clinicians to view the study in the larger context of medical research.


Am Heart J


American heart journal


Berry DA,Berry SM,McKellar J,Pearson TA




Has Abstract


2003-06-01 00:00:00














  • Drinking and coronary heart disease: the Albany Study.

    abstract::The relation of alcohol consumption to coronary heart disease (CHD) was examined in a cohort of 1910 employed men aged 38 to 55 years enrolled in the Albany Study, a prospective investigation of factors related to cardiovascular disease. Two follow-up periods were examined, one between 1953-54 and 1971-72, the other a...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Gordon T,Doyle JT

    更新日期:1985-08-01 00:00:00

  • Accelerated treatment of endocarditis-The POET II trial: Rationale and design of a randomized controlled trial.

    abstract:BACKGROUND:The optimal antibiotic treatment length for infective endocarditis (IE) is uncertain. International guidelines recommend treatment duration of up to 6 weeks for patients with left-sided IE but are primarily based on historical data and expert opinion. Efficacies of modern therapies, fast recovery seen in man...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Østergaard L,Pries-Heje MM,Hasselbalch RB,Rasmussen M,Åkesson P,Horvath R,Povlsen J,Gill S,Bruun NE,Müllertz K,Tuxen CD,Ihlemann N,Helweg-Larsen J,Moser C,Fosbøl EL,Bundgaard H,Iversen K

    更新日期:2020-09-01 00:00:00

  • Ischemia at rest is independent of the extent of ventricular dysfunction and arrhythmias in patients with coronary artery disease.

    abstract::To assess the relation between myocardial ischemia, ventricular arrhythmias (VA), and left ventricular (LV) dysfunction, we evaluated 74 patients with coronary artery disease (CAD) using radionuclide angiography (to determine the resting ejection fraction [EF]), resting thallium-201 scintigraphy (to ascertain the exte...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Edlin DE,Morganroth J,Iskandrian AS,Speilman SR,Horowitz LN,Kay H

    更新日期:1985-02-01 00:00:00

  • Histoplasma capsulatum endocarditis.

    abstract::Endocarditis is a rare manifestation of disseminated Histoplasma capsulatum infection. A 22-year-old man presented with a seven month history of fever, weight loss, and progressive aortic insufficiency. The diagnosis of H. capsulatum was suggested by a diagnostic rise in complement fixation titers and positive echocar...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Blair TP,Waugh RA,Pollack M,Ashworth HE,Young NA,Anderson SE,Bem TP

    更新日期:1980-06-01 00:00:00

  • Twenty-five-year mortality rate decrease in patients in Israel with a first episode of acute myocardial infarction. Secondary Prevention Reinfarction Israeli Nifedipine Trial Study Group. Israeli Thrombolytic Survey Group.

    abstract::The aim of our study was to compare the outcome of patients with a first acute myocardial infarction (AMI) among three large cohorts of patients hospitalized between 1966 and 1992 in Israel, in view of changes in treatment facilities and investigation methods. Patients with a first AMI constituted 71% of all myocardia...

    journal_title:American heart journal

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Behar S,Goldbourt U,Barbash G,Modan B

    更新日期:1995-09-01 00:00:00

  • Drug-eluting stents for the treatment of bifurcation lesions: a randomized comparison between paclitaxel and sirolimus stents.

    abstract:BACKGROUND:Drug-eluting stents have been shown to reduce restenosis in many types of lesions. The purpose of this article is to assess the efficacy of sirolimus- and paclitaxel-eluting stents in patients with bifurcation lesions. METHODS:Between June 2003 and October 2004, 205 patients were enrolled in a prospective r...

    journal_title:American heart journal

    pub_type: 杂志文章,随机对照试验


    authors: Pan M,Suárez de Lezo J,Medina A,Romero M,Delgado A,Segura J,Ojeda S,Mazuelos F,Hernandez E,Melian F,Pavlovic D,Esteban F,Herrador J

    更新日期:2007-01-01 00:00:00

  • Appropriate cardiac cath lab activation: optimizing electrocardiogram interpretation and clinical decision-making for acute ST-elevation myocardial infarction.

    abstract::During the last few decades, acute ST-elevation on an electrocardiogram (ECG) in the proper clinical context has been a reliable surrogate marker of acute coronary occlusion requiring primary percutaneous coronary intervention (PPCI). In 2004, the American College of Cardiology/American Heart Association ST-elevation ...

    journal_title:American heart journal

    pub_type: 杂志文章,评审


    authors: Rokos IC,French WJ,Mattu A,Nichol G,Farkouh ME,Reiffel J,Stone GW

    更新日期:2010-12-01 00:00:00

  • Clinical setting and prognostic significance of high degree atrioventricular block in acute inferior myocardial infarction: a study of 144 patients.

    abstract::High degree AV block occurred in 144 of 843 patients consecutively admitted because of acute inferior myocardial infarction and was associated with more extensive myocardial damage and a higher mortality rate, as compared to those without AV block. Patients with power failure at the time of appearance of high degree A...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Tans AC,Lie KI,Durrer D

    更新日期:1980-01-01 00:00:00

  • The effects of cytochrome C on the extent of myocardial infarction and regional function of the ischemic myocardium.

    abstract::The effects of cytochrome C, an electron carrier in the process of oxidative phosphorylation, on infarct size and regional left ventricular function after a coronary artery occlusion were investigated. Thus, in 30 dogs, 1 minute after left anterior descending coronary artery occlusion, 99mTc-labeled albumin microspher...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Zalewski A,Goldberg S,Krol R,Maroko PR

    更新日期:1987-01-01 00:00:00

  • An open, noncomparative study of doxazosin in essential hypertension: experience in general practice in The Netherlands.

    abstract::The antihypertensive efficacy, safety, and lipid effects of doxazosin, a selective alpha 1-inhibitor, were assessed in a general practice setting. Three hundred twenty-six patients were entered into the study, which involved three phases: (1) a 2-week baseline period, (2) an 8-week period in which patients received 1 ...

    journal_title:American heart journal

    pub_type: 临床试验,杂志文章


    authors: Naber FB

    更新日期:1991-01-01 00:00:00

  • The stent decade: 1987 to 1997. Stanford Stent Summit faculty.

    abstract::In January 1997, experts from the United States, Europe, and Japan gathered at Stanford University to review their collective experience with intracoronary and noncoronary stenting and to identify and prioritize issues requiring further clinical investigation. This report summarizes the discussions that took place dur...

    journal_title:American heart journal

    pub_type: 杂志文章,评审


    authors: Oesterle SN,Whitbourn R,Fitzgerald PJ,Yeung AC,Stertzer SH,Dake MD,Yock PG,Virmani R

    更新日期:1998-10-01 00:00:00

  • Two-dimensional echocardiographic study of right ventricular outflow and great artery anatomy in pulmonary atresia with ventricular septal defects and in truncus arteriosus.

    abstract::In this study, we reviewed M-mode and two-dimensional (2DE) echocardiographic observations in 13 patients with pulmonary atresia with ventricular septal defect and in six patients with truncus arteriosus in order to attempt to identify echocardiographic features distinguishing these two abnormalities in which no anato...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Vargas Barron J,Sahn DJ,Attie F,Valdes-Cruz LM,Grenadier E,Allen HD,Oliveira Lima C,Goldberg SJ

    更新日期:1983-02-01 00:00:00

  • Truncus arteriosus communis. Clinical, angiocardiographic, and pathologic findings in 100 patients.

    abstract::Salient clinical, hemodynamic, angiocardiographic, and pathologic findings are presented in 100 patients with truncus arteriosus communis, 79 of whom were studied at autopsy. In this study of typical truncus, all had a ventricular septal defect (type A). Truncus with a partially formed aorticopulmonary septum (type A1...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Calder L,Van Praagh R,Van Praagh S,Sears WP,Corwin R,Levy A,Keith JD,Paul MH

    更新日期:1976-07-01 00:00:00

  • The prognostic value of the changes in the mode of ventricular tachycardia induction noted during therapy with a marked reduction of ventricular ectopic activity.

    abstract::The prognostic significance of changes in the mode of induction of ventricular tachycardia (VT) noted during therapy was studied in 49 patients with sustained VT or ventricular fibrillation. Before treatment, all patients had inducible sustained VT by programmed stimulation (one to three extrastimuli) and frequent (gr...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Kim SG,Felder SD,Seiden SW,Waspe LE,Fisher JD

    更新日期:1987-11-01 00:00:00

  • Incidence of atrial fibrillation in whites and African-Americans: the Atherosclerosis Risk in Communities (ARIC) study.

    abstract:OBJECTIVES:To define the incidence and cumulative risk of atrial fibrillation (AF) in a population-based cohort of whites and African Americans. BACKGROUND:African-Americans reportedly have a lower risk of AF than whites despite their higher exposure to AF risk factors. However, precise estimates of AF incidence in Af...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Alonso A,Agarwal SK,Soliman EZ,Ambrose M,Chamberlain AM,Prineas RJ,Folsom AR

    更新日期:2009-07-01 00:00:00

  • Outpatient dobutamine and dopamine infusions in the management of chronic heart failure: clinical experience in 21 patients.

    abstract::Dobutamine (and dopamine) are potent positive inotropic drugs which are frequently given to treat decompensated congestive heart failure. This study reports on the use of ambulatory dobutamine (and dopamine) infusions in 21 outpatients with advanced congestive heart failure. Each patient was initially hospitalized, an...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Applefeld MM,Newman KA,Sutton FJ,Reed WP,Roffman DS,Talesnick BS,Grove WR

    更新日期:1987-09-01 00:00:00

  • Rapid, sensitive detection of myoglobulinemia by improved counterimmunoelectrophoresis in cases of acute myocardial infarction.

    abstract::A counterimmunoelectrophoresis technique for detection of serum myoglobin (Mb) was improved using non-ionic polymer dextran. Precipitin lines were graded according to their strength, which was ascertained by radioimmunoassay data. By this method, serum Mb in concentrations of 500 ng./ml. before stain and of 200 ng./ml...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Hiramori K,Sumiyoshi T,Motegi S,Honda T,Kimata S,Hirosawa K,Kawai H,Kondo A,Iwaasa M,Miyoshi K

    更新日期:1978-08-01 00:00:00

  • Perivalvular cavities in endocarditis: abscesses versus pseudoaneurysms? A transesophageal Doppler echocardiographic study in 118 patients with endocarditis.

    abstract::The appearance of perivalvular cavities (PCs) in patients with infectious endocarditis (IE) was studied by transesophageal echocardiography (TEE) color Doppler examinations to determine whether the color Doppler TEE presentation was in keeping with the current concept of PCs representing abscesses. Two heart centers p...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Tingleff J,Egeblad H,Gøtzsche CO,Baandrup U,Kristensen BO,Pilegaard H,Pettersson G

    更新日期:1995-07-01 00:00:00

  • Effect of concealed anterograde impulse penetration on retrograde atrioventricular nodal conduction in man.

    abstract::The manner in which concealed anterograde impulse penetration may affect retrograde atrioventricular nodal conduction was studied systematically in 12 patients with intact ventriculoatrial (VA) conduction. After the last beat of a basic atrial drive (A1), an extrastimulus (A2) was introduced 20 msec inside the effecti...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Lehmann MH,Mahmud R,Denker ST,Tchou PJ,Dongas J,Akhtar M

    更新日期:1987-12-01 00:00:00

  • Within-patient comparison of effects of different dosages of enalapril on functional capacity and neurohormone levels in patients with chronic heart failure.

    abstract:BACKGROUND:Angiotensin-converting enzyme (ACE) inhibitors are established as first-line therapy in chronic heart failure (CHF). However, conflicting results exist regarding the dose-effect relation of ACE inhibitors. METHODS:We investigated 45 patients (age 55 +/- 10 years) with stable CHF who presented with a mainten...

    journal_title:American heart journal

    pub_type: 临床试验,杂志文章


    authors: Brunner-La Rocca HP,Weilenmann D,Kiowski W,Maly FE,Candinas R,Follath F

    更新日期:1999-10-01 00:00:00

  • Effects of nadolol treatment on renal and hepatic hemodynamics and function in cirrhotic patients with portal hypertension.

    abstract::Twelve cirrhotic patients with portal hypertension and esophageal varices were treated with nadolol for 1 month, and the effects on renal and hepatic hemodynamics and function were studied. A significant decrease in cardiac output, portohepatic gradient, and effective hepatic blood flow was found, whereas mean arteria...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Gatta A,Sacerdoti D,Merkel C,Milani L,Battaglia G,Zuin R

    更新日期:1984-10-01 00:00:00

  • Race and ethnicity influences on cardiovascular and renal events in patients with diabetes mellitus.

    abstract:BACKGROUND:The incidence of end-stage renal disease (ESRD) has been consistently shown to be higher among blacks and Hispanics compared to whites with unmeasured risk factors and access to care as suggested explanations. In a high-risk cohort with frequent protocol-directed follow-up, we evaluated the influence of race...

    journal_title:American heart journal

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Lewis EF,Claggett B,Parfrey PS,Burdmann EA,McMurray JJ,Solomon SD,Levey AS,Ivanovich P,Eckardt KU,Kewalramani R,Toto R,Pfeffer MA

    更新日期:2015-08-01 00:00:00

  • Decreased incidence of antiarrhythmic drug efficacy at electrophysiologic study associated with the use of a third extrastimulus.

    abstract::Drug trials during electrophysiologic study were performed in 166 patients with sustained ventricular tachycardia (VT) or ventricular fibrillation. In the first 21 patients (group I), a maximum of two extrastimuli was used. In 145 subsequent patients (group II), drug efficacy was assessed using three extrastimuli if o...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Swerdlow CD,Blum J,Winkle RA,Griffin JC,Ross DL,Mason JW

    更新日期:1982-11-01 00:00:00

  • Acute effects of cardiac resynchronization therapy on left ventricular Doppler indices in patients with congestive heart failure.

    abstract:BACKGROUND:Patients with heart failure frequently exhibit intraventricular conduction delays, which contribute to asynchronous contraction patterns and impaired hemodynamic performance. Cardiac resynchronization therapy (CRT) with biventricular (BV) and left ventricular (LV) pacing has been shown to improve both hemody...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Breithardt OA,Stellbrink C,Franke A,Balta O,Diem BH,Bakker P,Sack S,Auricchio A,Pochet T,Salo R,Pacing Therapies for Congestive Heart Failure Study Group.,Guidant Congestive Heart Failure Research Group.

    更新日期:2002-01-01 00:00:00

  • Time of day and outcomes of nonurgent percutaneous coronary intervention performed during working hours.

    abstract:BACKGROUND:During daytime working hours, outcomes may be worse when percutaneous coronary intervention (PCI) is performed later in the day because of operator fatigue and differences in process of care. METHODS:Using the APPROACH database, we analyzed 2,492 consecutive nonurgent PCI procedures performed during working...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Cantor WJ,Strauss BH,Graham MM,Southern DA,Woo K,Tyrrell B,Knudtson M,Ghali WA

    更新日期:2010-06-01 00:00:00

  • Diagnostic value of 12-lead electrocardiogram during dobutamine echocardiographic studies.

    abstract:BACKGROUND:The diagnostic value of 12-lead electrocardiography during dobutamine stress echocardiography (DSE) is not well documented. METHODS AND RESULTS:We reviewed the records of 116 patients referred for DSE and coronary angiography, 52 of whom were excluded because of abnormal ST segment or inadequate DSE. Of the...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Shaheen J,Luria D,Klutstein MW,Rosenmann D,Tzivoni D

    更新日期:1998-12-01 00:00:00

  • Blood pressure variability and prognosis in uncomplicated mild hypertension.

    abstract:BACKGROUND:The independent prognostic value of blood pressure (BP) variability in essential hypertension and particularly in uncomplicated mild hypertension is not yet completely clear. We investigated the relationship between BP variability, evaluated by noninvasive monitoring, and cardiovascular outcome in uncomplica...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Pierdomenico SD,Lapenna D,Bucci A,Manente BM,Mancini M,Cuccurullo F,Mezzetti A

    更新日期:2005-05-01 00:00:00

  • Telemedicine in myocarditis: Evolution of a mutidisciplinary "disease unit" at the time of COVID-19 pandemic.

    abstract::Myocarditis Disease Unit (MDU) is a functional multidisciplinary network designed to offer multidisciplinary assistance to patients with myocarditis. More than 300 patients coming from the whole Country are currently followed up at a specialized multidisciplinary outpatient clinic. Following the pandemic outbreak of t...

    journal_title:American heart journal

    pub_type: 信件


    authors: Peretto G,De Luca G,Campochiaro C,Palmisano A,Busnardo E,Sartorelli S,Barzaghi F,Cicalese MP,Esposito A,Sala S

    更新日期:2020-11-01 00:00:00

  • Aggressive hydraTion in patients with ST-Elevation Myocardial infarction undergoing Primary percutaneous coronary intervention to prevenT contrast-induced nephropathy (ATTEMPT): Study design and protocol for the randomized, controlled trial, the ATTEMPT,

    abstract::Adequate hydration is recommended for acute ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) to prevent contrast-induced nephropathy (CIN). However, the optimal hydration regimen has not been well established in these high-risk patients. The objective of t...

    journal_title:American heart journal

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Liu Y,Chen JY,Huo Y,Ge JB,Xian Y,Duan CY,Chen SQ,Jiang W,Chen PY,Tan N,RESCIND group.

    更新日期:2016-02-01 00:00:00

  • Pathophysiologic mechanisms underlying dobutamine- and exercise-induced wall motion abnormalities.

    abstract:BACKGROUND:Dobutamine and exercise echocardiography are accepted as tests of comparable efficacy for the diagnosis of coronary artery disease. Although dobutamine has been classified as "exercise simulating," the mechanisms of ischemia with dobutamine and exercise have not been well studied. This study sought to compar...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Mairesse GH,Vanoverschelde JL,Robert A,Climov D,Detry JM,Marwick TH

    更新日期:1998-07-01 00:00:00