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dc.contributor.authorParfrey, PSen_US
dc.contributor.authorDrüeke, TBen_US
dc.contributor.authorBlock, GAen_US
dc.contributor.authorCorrea-Rotter, Ren_US
dc.contributor.authorFloege, Jen_US
dc.contributor.authorHerzog, CAen_US
dc.contributor.authorLondon, GMen_US
dc.contributor.authorMahaffey, KWen_US
dc.contributor.authorMoe, SMen_US
dc.contributor.authorWheeler, DCen_US
dc.contributor.authorKubo, Yen_US
dc.contributor.authorDehmel, Ben_US
dc.contributor.authorGoodman, WGen_US
dc.contributor.authorChertow, GMen_US
dc.contributor.authorEvaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) Trial Investigatorsen_US
dc.descriptionThis article contains supplemental material online at http://cjasn. DCSupplemental.en_US
dc.description.abstractBACKGROUND AND OBJECTIVES: The calcimimetic cinacalcet reduced the risk of death or cardiovascular (CV) events in older, but not younger, patients with moderate to severe secondary hyperparathyroidism (HPT) who were receiving hemodialysis. To determine whether the lower risk in younger patients might be due to lower baseline CV risk and more frequent use of cointerventions that reduce parathyroid hormone (kidney transplantation, parathyroidectomy, and commercial cinacalcet use), this study examined the effects of cinacalcet in older (≥65 years, n=1005) and younger (<65 years, n=2878) patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) was a global, multicenter, randomized placebo-controlled trial in 3883 prevalent patients on hemodialysis, whose outcomes included death, major CV events, and development of severe unremitting HPT. The age subgroup analysis was prespecified. RESULTS: Older patients had higher baseline prevalence of diabetes mellitus and CV comorbidity. Annualized rates of kidney transplantation and parathyroidectomy were >3-fold higher in younger relative to older patients and were more frequent in patients randomized to placebo. In older patients, the adjusted relative hazard (95% confidence interval) for the primary composite (CV) end point (cinacalcet versus placebo) was 0.70 (0.60 to 0.81); in younger patients, the relative hazard was 0.97 (0.86 to 1.09). Corresponding adjusted relative hazards for mortality were 0.68 (0.51 to 0.81) and 0.99 (0.86 to 1.13). Reduction in the risk of severe unremitting HPT was similar in both groups. CONCLUSIONS: In the EVOLVE trial, cinacalcet decreased the risk of death and of major CV events in older, but not younger, patients with moderate to severe HPT who were receiving hemodialysis. Effect modification by age may be partly explained by differences in underlying CV risk and differential application of cointerventions that reduce parathyroid hormone.en_US
dc.description.sponsorshipThe Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) trial was funded by Amgen.en_US
dc.format.extent791 - 799en_US
dc.relation.ispartofClin J Am Soc Nephrolen_US
dc.subjectcardiovascular diseaseen_US
dc.subjectmineral metabolismen_US
dc.subjectAge Factorsen_US
dc.subjectAged, 80 and overen_US
dc.subjectCalcimimetic Agentsen_US
dc.subjectCardiovascular Diseasesen_US
dc.subjectHyperparathyroidism, Secondaryen_US
dc.subjectKidney Failure, Chronicen_US
dc.subjectKidney Transplantationen_US
dc.subjectMiddle Ageden_US
dc.subjectRenal Dialysisen_US
dc.subjectSeverity of Illness Indexen_US
dc.titleThe Effects of Cinacalcet in Older and Younger Patients on Hemodialysis: The Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) Trial.en_US
pubs.notesNot knownen_US

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