RT Journal Article
T1 Effect of Alirocumab on Lipoprotein(a) and Cardiovascular Risk After Acute Coronary Syndrome.
A1 Bittner, Vera A
A1 Szarek, Michael
A1 Aylward, Philip E
A1 Bhatt, Deepak L
A1 Diaz, Rafael
A1 Edelberg, Jay M
A1 Fras, Zlatko
A1 Goodman, Shaun G
A1 Halvorsen, Sigrun
A1 Hanotin, Corinne
A1 Harrington, Robert A
A1 Jukema, J Wouter
A1 Loizeau, Virginie
A1 Moriarty, Patrick M
A1 Moryusef, Angèle
A1 Pordy, Robert
A1 Roe, Matthew T
A1 Sinnaeve, Peter
A1 Tsimikas, Sotirios
A1 Vogel, Robert
A1 White, Harvey D
A1 Zahger, Doron
A1 Zeiher, Andreas M
A1 Steg, Ph Gabriel
A1 Schwartz, Gregory G
A1 ODYSSEY OUTCOMES Committees and Investigators, 
K1 acute coronary syndromes
K1 alirocumab
K1 low-density lipoprotein cholesterol
K1 major adverse cardiovascular events
K1 proprotein convertase subtilisin/kexin type 9 inhibition
AB Lipoprotein(a) concentration is associated with cardiovascular events. Alirocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, lowers lipoprotein(a) and low-density lipoprotein cholesterol (LDL-C). A pre-specified analysis of the placebo-controlled ODYSSEY Outcomes trial in patients with recent acute coronary syndrome (ACS) determined whether alirocumab-induced changes in lipoprotein(a) and LDL-C independently predicted major adverse cardiovascular events (MACE). One to 12 months after ACS, 18,924 patients on high-intensity statin therapy were randomized to alirocumab or placebo and followed for 2.8 years (median). Lipoprotein(a) was measured at randomization and 4 and 12 months thereafter. The primary MACE outcome was coronary heart disease death, nonfatal myocardial infarction, ischemic stroke, or hospitalization for unstable angina. Baseline lipoprotein(a) levels (median: 21.2 mg/dl; interquartile range [IQR]: 6.7 to 59.6 mg/dl) and LDL-C [corrected for cholesterol content in lipoprotein(a)] predicted MACE. Alirocumab reduced lipoprotein(a) by 5.0 mg/dl (IQR: 0 to 13.5 mg/dl), corrected LDL-C by 51.1 mg/dl (IQR: 33.7 to 67.2 mg/dl), and reduced the risk of MACE (hazard ratio [HR]: 0.85; 95% confidence interval [CI]: 0.78 to 0.93). Alirocumab-induced reductions of lipoprotein(a) and corrected LDL-C independently predicted lower risk of MACE, after adjustment for baseline concentrations of both lipoproteins and demographic and clinical characteristics. A 1-mg/dl reduction in lipoprotein(a) with alirocumab was associated with a HR of 0.994 (95% CI: 0.990 to 0.999; p = 0.0081). Baseline lipoprotein(a) and corrected LDL-C levels and their reductions by alirocumab predicted the risk of MACE after recent ACS. Lipoprotein(a) lowering by alirocumab is an independent contributor to MACE reduction, which suggests that lipoprotein(a) should be an independent treatment target after ACS. (ODYSSEY Outcomes: Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab; NCT01663402).
YR 2020
FD 2020
LK https://hdl.handle.net/10668/25088
UL https://hdl.handle.net/10668/25088
LA en
DS RISalud
RD Apr 5, 2025