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ATP III Update 2004: Implications of Recent Clinical Trials for the ATP III Guidelines Updates and Disclosures

Updating of the Adult Treatment Panel III (ATP III) guidelines was initiated because recent clinical trials had provided evidence regarding several significant issues pertaining to the benefits of cholesterol lowering. The purpose of the update is to translate the scientific evidence into guidance that helps professionals and the public take appropriate action to reduce the risk for coronary heart disease and cardiovascular disease, the leading killer of women and of men in the United States.

The members of the working group responsible for drafting the update were selected for their expertise primarily from the members of the expert panel that developed the original ATP III guidelines released in 2001 (Drs. Grundy, Cleeman, Brewer, Clark, Hunninghake, Pasternak, and Stone). In addition to these seven individuals, the working group included an expert representative of the American College of Cardiology (Dr. Bairey Merz) and of the American Heart Association (Dr. Smith).

The working group conducted a critical scientific review of the 5 relevant clinical trials and assessed the implications of the trials for the ATP III guidelines. When the update had been drafted, it was subjected to multiple layers of scientific review, first by the Coordinating Committee of the National Cholesterol Education Program, consisting of 35 representatives of leading medical, public health, voluntary, community, and citizen organizations and Federal agencies, and then by the scientific and steering committees of the American Heart Association and the American College of Cardiology. Altogether approximately 90 reviewers scrutinized the draft. Their review was the basis for the endorsement of the update by the National Heart, Lung, and Blood Institute, American College of Cardiology, and American Heart Association.

ATP III Update 2004:  Financial Disclosure

Dr. Grundy has received honoraria from Merck, Pfizer, Sankyo, Bayer, Merck/Schering-Plough, Kos, Abbott, Bristol-Myers Squibb, and AstraZeneca; he has received research grants from Merck, Abbott, and Glaxo Smith Kline.

Dr. Cleeman has no financial relationships to disclose.

Dr. Bairey Merz has received lecture honoraria from Pfizer, Merck, and Kos; she has served as a consultant for Pfizer, Bayer, and EHC (Merck); she has received unrestricted institutional grants for Continuing Medical Education from Pfizer, Procter & Gamble, Novartis, Wyeth, AstraZeneca, and Bristol-Myers Squibb Medical Imaging; she has received a research grant from Merck; she has stock in Boston Scientific, IVAX, Eli Lilly, Medtronic, Johnson & Johnson, SCIPIE Insurance, ATS Medical, and Biosite.

Dr. Brewer has received honoraria from AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering-Plough, Fournier, Tularik, Esperion, and Novartis; he has served as a consultant for AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering-Plough, Fournier, Tularik, Sankyo, and Novartis.

Dr. Clark has received honoraria for educational presentations from Abbott, AstraZeneca, Bristol-Myers Squibb, Merck, and Pfizer; he has received grant/research support from Abbott, AstraZeneca, Bristol-Myers Squibb, Merck, and Pfizer.

Dr. Hunninghake has received honoraria for consulting and speakers bureau from AstraZeneca, Merck, Merck/Schering-Plough, and Pfizer, and for consulting from Kos; he has received research grants from AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, and Pfizer.

Dr. Pasternak has served as a speaker for Pfizer, Merck, Merck/Schering-Plough, Takeda, Kos, BMS-Sanofi, and Novartis; he has served as a consultant for Merck, Merck/Schering-Plough, Sanofi, Pfizer Health Solutions, Johnson & Johnson-Merck, and AstraZeneca.

Dr. Smith has received institutional research support from Merck; he has stock in Medtronic and Johnson & Johnson.

Dr. Stone has received honoraria for educational lectures from Abbott, AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, Pfizer, Reliant, and Sankyo; he has served as a consultant for Abbott, Merck, Merck/Schering-Plough, Pfizer, and Reliant.

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