Cardiovascular disease — HCA2 niacin receptor; DP1 (laropiprant)

Adding fenofibrate to statin therapy would lower cardiovascular events in high-risk patients with type 2 diabetes, compared with a statin alone.

Across 5,518 patients followed for a mean 4.7 years, the primary outcome (nonfatal MI, nonfatal stroke or cardiovascular death) ran at 2.2% a year with fenofibrate vs 2.4% with placebo (HR 0.92, P=0.32), with no difference on any secondary outcome.

Why it matched: same research area · similar wording · mechanism: Lipid & cholesterol handling

Spironolactone, which improves outcomes in heart failure with reduced ejection fraction, would do the same in heart failure with preserved ejection fraction.

In 3,445 patients with ejection fraction of 45% or more over a mean 3.3 years, the primary composite (cardiovascular death, aborted cardiac arrest or heart-failure hospitalization) occurred in 18.6% vs 20.4% on placebo (HR 0.89, P=0.14). Hyperkalemia doubled (18.7% vs 9.1%).

Why it matched: same research area

Lowering LDL cholesterol with statins, especially to very low levels, would change cancer risk.

In individual data from 175,000 people in 27 trials, about 5 years of statin therapy had no effect on cancer incidence (RR 1.00) or cancer death (RR 1.00), at any of 23 cancer sites, for any statin, or in people who started with low LDL.

Why it matched: similar wording · mechanism: Lipid & cholesterol handling