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Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial
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 Effects of alirocumab on types of myocardial infarction insights from the ODYSSEY OUTCOMES trial.pdf | Published version | 627.41 kB | Adobe PDF | View/Open |
| Title: | Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial |
| Authors: | White, HD Steg, PG Szarek, M Bhatt, DL Bittner, VA Diaz, R Edelberg, JM Erglis, A Goodman, SG Hanotin, C Harrington, RA Jukema, JW Lopes, RD Mahaffey, KW Moryusef, A Pordy, R Roe, MT Sritara, P Tricoci, P Zeiher, AM Schwartz, GG Aylward, PE Drexel, H Sinnaeve, P Dilic, M Lopes, RD Gotcheva, NN Goodman, SG Prieto, J-C Yong, H Lopez-Jaramillo, P Pecin, I Reiner, Z Ostadal, P Poulsen, SH Viigimaa, M Nieminen, MS Danchin, N Chumburidze, V Marx, N Liberopoulos, E Montenegro Valdovinos, PC Tse, H-F Kiss, RG Xavier, D Zahger, D Valgimigli, M Kimura, T Kim, HS Kim, S-H Erglis, A Laucevicius, A Kedev, S Yusoff, K Ramos Lopez, GA Alings, M Halvorsen, S Correa Flores, RM Sy, RG Budaj, A Morais, J Dorobantu, M Karpov, Y Ristic, AD Chua, T Murin, J Fras, Z Dalby, AJ Tunon, J De Silva, HA Hagstrom, E Muller, C Chiang, C-E Sritara, P Guneri, S Parkhomenko, A Ray, KK Moriarty, PM Vogel, R Chaitman, B Kelsey, SF Olsson, AG Rouleau, J-L Simoons, ML Alexander, K Meloni, C Rosenson, R Sijbrands, EJG Alexander, JH Armaganijan, L Bagai, A Bahit, MC Brennan, JM Clifton, S DeVore, AD Deloatch, S Dickey, S Dombrowski, K Ducrocq, G Eapen, Z Endsley, P Eppinger, A Hess, CN Hlatky, MA Jordan, JD Knowles, JW Kolls, BJ Kong, DF Leonardi, S Lillis, L Lopes, RD Maron, DJ Marcus, J Mathews, R Mehta, RH Mentz, RJ Moreira, HG Patel, CB Pereira, SB Perkins, L Povsic, TJ Puymirat, E Jones, WS Shah, BR Sherwood, MW Stringfellow, K Sujjavanich, D Toma, M Trotter, C Van Diepen, SFP Wilson, MD Yan, AT-K Schiavi, LB Garrido, M Alvarisqueta, AF Sassone, SA Bordonava, AP Alves De Lima, AE Schmidberg, JM Duronto, EA Caruso, OC Novaretto, LP Angel Hominal, M Montana, OR Caccavo, A Gomez Vilamajo, OA Lorenzatti, AJ Cartasegna, LR Paterlini, GA Mackinnon, IJ Caime, GD Amuchastegui, M Codutti, OR Jure, HO Bono, JOE Hrabar, AD Vallejos, JA Ahuad Guerrero, RA Novoa, F Patocchi, CA Zaidman, CJ Giuliano, ME Dran, RD Vico, ML Carnero, GS Guzman, PN Medrano Allende, JC Garcia Brasca, DF Bustamante Labarta, MH Nani, S Blumberg, EDS Colombo, HR Liberman, A Luciardi, HL Waisman, GD Berli, MA Garcia Duran, RO Cestari, HG Luquez, HA Giordano, JA Saavedra, SS Waites, JH Collins, N Soward, A Hii, CLS Shaw, J Arstall, MA Horowitz, J Rogers, JF Colquhoun, D Flores, REO Roberts-Thomson, P Raffel, O Lehman, SJ Coverdale, SGM Garrahy, PJ Starmer, G Sader, M Carroll, PA Zweiker, R Hoppe, U Huber, K Berger, R Weidinger, F Faes, D Hermans, K Pirenne, B Leone, A Hoffer, E Vrolix, MCM De Wolf, L Wollaert, B Castadot, M Dujardin, K Beauloye, C Vervoort, G Striekwold, H Convens, C Roosen, J Barbato, E Claeys, M Cools, F Terzic, I Barakovic, F Midzic, Z Pojskic, B Fazlibegovic, E Durak-Nalbantic, A Vulic, D Muslibegovic, A Reis, G Sousa, L Nicolau, JC Giorgeto, FE Silva, RP Maia, LN Rech, R Rossi, PRF Cerqueira, MJAG Duda, N Kalil, R Kormann, A Abrantes, JAM Pimentel Filho, P Soggia, AP De Santos, MON Neuenschwander, F Bodanese, LC Michalaros, YL Eliaschewitz, FG Vidotti, MH Leaes, PE Botelho, RV Kaiser, S Fernandes Manenti, ERF Precoma, DB Moura Jorge, JC Silva, PGMDB Silveira, JA Saporito, W Marin Neto, JA Feitosa, GS Ritt, LEF De Souza, JA Costa, F Souza, WKSB Reis, HJL Lopes, RD Machado, L Aidar Ayoub, JC Todorov, GV Nikolov, FP Velcheva, ES Tzekova, ML Benov, HO Petranov, SL Tumbev, HS Shehova-Yankova, NS Markov, DT Raev, DH Mollov, MN Kichukov, KN Ilieva-Pandeva, KA Gotcheva, NN Ivanova, R Mincheva, VM Lazov, PV Dimov, BI Senaratne, M Stone, J Kornder, J Pearce, S Dion, D Savard, D Pesant, Y Pandey, A Robinson, S Gosselin, G Vizel, S Hoag, G Bourgeois, R Morisset, A Sabbah, E Sussex, B Kouz, S MacDonald, P Diaz, A Michaud, N Fell, D Leung, R Vuurmans, T Lai, C Nigro, F Davies, R Nogareda, G Vijayaraghavan, R Ducas, J Lepage, S Mehta, S Cha, J Dupuis, R Fong, P Rodes-Cabau, J Fadlallah, H Cleveland, D Huynh, T Bata, I Hameed, A Pincetti, C Potthoff, S Acevedo, M Aguirre, A Vejar, M Yanez, M Araneda, G Fernandez, M Perez, L Varleta, P Florenzano, F Huidobro, L Raffo, CA Olivares, C Chen, J Dong, Y Huang, W Wang, J Huang, S Yao, Z Cui, L Lin, W Sun, Y Wang, J Li, J Zhang, X Zhu, H Chen, D Huang, L Dong, S Su, G Xu, B Su, X Cheng, X Lin, J Zong, W Li, H Feng, Y Xu, D Yang, X Ke, Y Lin, X Zhang, Z Zheng, Z Luo, Z Chen, Y Ding, C Zheng, Y Li, X Peng, D Li, Y Wei, M Liu, S Yu, Y Qu, B Jiang, W Zhou, Y Zhao, X Yuan, Z Guo, Y Xu, X Shi, X Ge, J Fu, G Bai, F Fang, W Shou, X Yang, X Wang, J Jaramillo, N Vallejo, GS Botia, DCL Lopez, RB De Salazar, DIM Bonfanti, AJC Higuera, JD Silva, SIB Lozada, HJG Arroyo, JAC Mendoza, JLA Ruiz, RLF Fernandez, AM Jatin, FGM Herazo, AS Parada, JC Triana, MAU Spinar, J Horak, D Stasek, J Alan, D Machova, V Linhart, A Novotny, V Kaucak, V Rokyta, R Naplava, R Coufal, Z Adamkova, V Podpera, I Zizka, J Motovska, Z Marusincova, I Svab, P Heinc, P Kuchar, J Povolny, P Raungaard, B Clemmensen, P Bang, LE May, O Bottcher, M Hove, JD Frost, L Gislason, G Larsen, J Johansen, PB Hald, F Jeppesen, J Nielsen, T Kristensen, KS Walichiewicz, PM Lomholdt, JD Klausen, IC Nielsen, PK Davidsen, F Videbaek, L Soots, M Vahula, V Hedman, A Soopold, S Martsin, K Taskinen, M-R Porthan, K Airaksinen, JK Juonala, M Kiviniemi, T Vikman, S Posio, P Taurio, J Huikuri, H Kaikkonen, K Coste, P Ferrari, E Morel, O Montalescot, G Barone-Rochette, G Mansourati, J Cottin, Y Steg, PG Leclercq, F Belhassane, A Delarche, N Boccara, F Paganelli, F Clerc, J Schiele, F Aboyans, V Probst, V Berland, J Lefevre, T Khintibidze, I Shaburishvili, T Pagava, Z Ghlonti, R Lominadze, Z Khabeishvili, G Hemetsberger, R Rauch-Kroehnert, U Stratmann, M Appel, K-F Schmidt, E Omran, H Stellbrink, C Dorsel, T Lianopoulos, E Marx, R Zirlik, A Schellenberg, D Heitzer, T Laufs, U Marx, N Gielen, S Winkelmann, B Behrens, S Sydow, K Simonis, G Muenzel, T Werner, N Leggewie, S Boecker, D Braun-Dullaeus, R Toursarkissian, N Jeserich, M Weissbrodt, M Schaeufele, T Weil, J Voeller, H Waltenberger, J Natour, M Steiner, S Heidenreich, L Gremmler, U Killat, H Patsilinakos, S Kartalis, A Manolis, A Sionis, D Liberopoulos, E Skoumas, I Athyros, V Parthenakis, PIF Hahalis, PIG Lekakis, J Xatzitolios, A Fausto Ovando, SR Montenegro Valdovinos, PC Arango Benecke, JL Rodriguez De Leon, ER Yan, BPY Siu, DCW Turi, T Merkely, B Kiss, RG Ungi, I Lupkovics, G Nagy, L Katona, A Edes, I Muller, G Horvath, I Kapin, T Falukozy, J Kumbla, M Sandhu, M Annam, S Proddutur, NR Premchand, RK Mahajan, A Abhyanakar, AD Kerkar, P Govinda, RA Oomman, A Sinha, D Patil, SN Kahali, D Sawhney, J Joshi, AB Chaudhary, S Harkut, P Guha, S Porwal, S Jujjuru, S Pothineni, RB Monteiro, MR Khan, A Iyengar, SS Grewal, JS Chopda, M Fulwani, MC Patange, A Chopra, VK Goyal, NK Shinde, R Manakshe, GV Patki, N Sethi, S Munusamy, V Karna, S Adhyapak, S Pandurangi, U Mathur, R Kalashetti, S Bhagwat, A Raghuraman, B Yerra, SK Bhansali, P Borse, R Das, S Abdullakutty, J Saathe, S Palimkar, P Atar, S Shechter, M Mosseri, M Arbel, Y Lotan, C Rosenschein, U Katz, A Henkin, Y Francis, A Klutstein, M Nikolsky, E Turgeman, Y Halabi, M Kornowski, R Jonas, M Amir, O Rozenman, Y Fuchs, S Hussein, O Gavish, D Vered, Z Caraco, Y Elias, M Tov, N Piovaccari, G De Pellegrin, A Guardigli, G Licciardello, G Auguadro, C Cuccia, C Salvioni, A Musumeci, G Calabro, P Novo, S Faggiano, P De Cesare, NB Berti, S Cavallini, C Puccioni, E Galvani, M Tespili, M Piatti, P Palvarini, M De Luca, G Violini, R De Leo, A Filardi, PP Ferratini, M Dai, K Kamiya, H Ando, K Takeda, Y Morino, Y Hata, Y Kimura, K Kishi, K Michishita, I Uehara, H Higashikata, T Hirayama, A Hirooka, K Sakagami, S Taguchi, S Koike, A Fujinaga, H Koba, S Kozuma, K Kawasaki, T Ono, Y Shimizu, M Katsuda, Y Wada, A Shinke, T Ako, J Fujii, K Takahashi, T Sakamoto, T Furukawa, Y Sugino, H Mano, T Utsu, N Ito, K Haraguchi, T Ueda, Y Nishibe, A Fujimoto, K Yoon, JH Park, HS Chae, I-H Kim, MH Jeong, MH Rha, S Kim, C Hong, T Busmane, A Pontaga, N Strelnieks, A Mintale, I Sime, I Petrulioniene, Z Kavaliauskiene, R Jurgaitiene, R Sakalyte, G Slapikas, R Norkiene, S Misonis, N Kibarskis, A Kubilius, R Bojovski, S Lozance, N Kjovkaroski, A Doncovska, S Ong, TK Kasim, S Maskon, O Kandasamy, B Liew, HB Mohamed, WMIW Garcia Castillo, A Carrillo Calvillo, J Fajardo Campos, P Nunez Fragoso, JC Bayram Llamas, EA Alcocer Gamba, MA Carranza Madrigal, J Gonzalez Salas, LG Lopez Rosas, E Gonzalez Diaz, B Salcido Vazquez, E Nacoud Ackar, A Llamas Esperon, GA Martinez Sanchez, CR Guerrero De Leon, M Suarez Otero, R Fanghanel Salmon, G Perez Rios, JA Garza Ruiz, JA Breedveld, RW Hoogslag, PAM Suryapranata, H Oomen, A Wiersma, JJ Van Der Wal, RMA Van Huysduynen-Monraats, PSH Karalis, I Verdel, GJE Brueren, BRG Troquay, RPT Viergever, EP Al-Windy, NYY Bartels, GL Cornel, JH Hermans, WRM Herrman, JPR Bos, RJ Groutars, RGEJ Van Der Zwaan, CC Kaplan, R Ronner, E Groenemeijer, BE Bronzwaer, PNA Liem, AAH Rensing, BJWM Bokern, MJJA Nijmeijer, R Hersbach, FMRJ Willems, FF Gosselink, ATM Elliott, J Wilkins, G Fisher, R Scott, D Hart, H Stewart, R 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Cevc, M Lipar, L Cyster, HP Ranjith, N Corbett, C Bayat, J Makotoko, EM Kapp, IE Basson, MMDV Lottering, H Van Zyl, LJ Sebastian, PJ Pillay, T Saaiman, JA Commerford, PJ Cassimjee, S Ebrahim, IO Sarvan, M Mynhardt, JH Dalby, AJ Reuter, H Moodley, R Vida, M Cequier Fillat, AR Bodi Peris, V Fuentes Jimenez, F Marin, F Cruz Fernandez, JM Gil-Extremera, B Worner Diz, F Garcia-Dorado, D Iniguez, A Tunon Fernandez, J Gonzalez-Juanatey, JR Fernandez Portales, J Civeira Murillo, F Matas Pericas, L Luis Zamorano, J De Mora Martin, M Bruguera Cortada, J Alonso Martin, JJ De Berrazueta Fernandez, JR Diaz Fernandez, JF Garcia Lledo, JA Cosin Sales, J Botas Rodriguez, J Gusi Tragant, G Benedicto, A Gonzalez-Juanatey, C Camprubi Potau, M Plaza Perez, I Moris De La Tassa, C Loma-Osorio Rincon, P Balaguer Recena, J M Escudier, J Constantine, G Haniffa, R Tissera, N Amarasekera, S Fernando, N Jayawardena, J Santharaj, W Ekanayaka, R Mendis, S Senaratne, V Mayurathan, G Sirisena, T Rajapaksha, A Herath, JI Amarasena, N Berglund, S Rasmanis, G Hagstrom, E Witt, N Mourtzinis, G Nicol, P Hansen, O Romeo, S Jensen, SA Torstensson, I Jensen, SA Ahremark, U Sundelin, T Moccetti, T Mueller, C Mach, F Binder, R Chiang, C-E Tsai, W-C Ueng, K-C Lai, W-T Liu, M-E Hwang, J-J Yin, W-H Hsieh, I-C Lin, WH Kuo, J-Y Huang, T-Y Fang, C-Y Kaewsuwanna, P Soonfuang, W Jintapakorn, W Sukonthasarn, A Sritara, P Wongpraparut, N Sastravaha, K Sansanayudh, N Kehasukcharoen, W Piyayotai, D Camsari, A Kultursay, H Guneri, S Mutlu, B Ersanli, M Demirtas, M Kirma, C Ural, E Koldas, L Karpenko, O Prokhorov, A Vakaluyk, I Myshanych, H Reshotko, D Batushkin, V Rudenko, L Kovalskyi, I Kushnir, M Tseluyko, V Mostovoy, Y Stanislavchuk, M Kyiak, Y Karpenko, Y Malynovsky, Y Klantsa, A Kutniy, O Amosova, E Tashchuk, V Leshchuk, O Parkhomenko, A Rishko, M Kopytsya, M Yagensky, A Vatutin, M Bagriy, A Barna, OM Ushakov, O Dzyak, G Goloborodko, B Rudenko, A Trevelyan, J Zaman, A Lee, K Moriarty, A Aggarwal, RK Clifford, P Wong, Y-K Iqbal, SMR Subkovas, E Braganza, D Sarkar, D Storey, R Griffiths, H Mcclure, S Muthusamy, R Kurian, J Levy, T Barr, C Kadr, H Gerber, R Simaitis, A Soran, H Mathur, A Brodison, A Oliver, R Mudawi, T Reynolds, T Sharman, D Butler, R Wilkinson, P Lip, GYH Halcox, J Vardi, G Baldari, D Brabham, D Treasure, C Dahl, C Palmer, B Wiseman, A Khan, A Puri, S Mohart, AE Ince, C Flores, E Wright, S Cheng, S-C Rosenberg, M Rogers, W Kosinski, E Forgosh, L Waltman, J Khan, M Shoukfeh, M Dagher, G Lieber, I Kumar, P East, C Krichmar, P White, L Knickelbine, T Haldis, T Gillespie, E Suh, D Arif, I Akhter, F Carlson, E D'Urso, M El-Ahdab, F Nelson, W Harris, B Cohen, S Carter, L Sabatino, K Haddad, T Malik, A Rao, S Mulkay, A Jovin, I Klancke, K Malhotra, V Devarapalli, SK Koren, M Chandna, H Dodds, G Janik, M Moran, J Sumner, A Kobayashi, J Davis, W Yazdani, S Pasquini, J Thakkar, M Vedere, A Leimbach, W Rider, J Singh, N Shah, AV Moriarty, PM Janosik, D Pepine, C Berman, B Gelormini, J 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Rossi, P Joshi, P Khaira, AS Kumkumian, G Lupovitch, S Purow, J Welka, S Hoffman, D Fischer, S Soroka, E Eagerton, D Pancholy, S Ray, M Farrar, M Pollock, S French, WJ Diamantis, S Gimple, L Schwartz, S Pereira, E Spriggs, D Strain, J Vo, A Chane, M Hall, J Vijay, N Lotun, K Lester, FM Nahhas, A Pope, T Nager, P Vohra, R Bashir, R Ahmed, H Berlowitz, M Fishberg, R Barrucco, R Yang, E Radin, M Sporn, D Eisenberg, S Landzberg, J Mcgough, M Turk, S Schwartz, M Sundram, PS Jain, D Zainea, M Bayron, C Karlsberg, R Lui, H Keen, W Westerhausen, D Khurana, S Agarwal, H Birchem, J Penny, W Chang, M Gilbert, JM Chalavarya, G Eaton, C Schmedtje, JF Christenson, S Denham, D Macdonell, A Gibson, P Rahman, A Al Joundi, T Conrad, G Kotha, P Love, M Giesler, G Rubenstein, H Akright, L Schifferdecker, B Krawczyk, J Wells, T Welker, J Foster, R Gilmore, R Anderson, J Jacoby, D Harris, B Gardner, G Dandillaya, R Vora, K Kostis, J Hunter, J Laxson, D Ball, E |
| Item Type: | Journal Article |
| Abstract: | Aims The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types. |
| Issue Date: | 1-Sep-2019 |
| Date of Acceptance: | 24-Apr-2019 |
| URI: | http://hdl.handle.net/10044/1/78926 |
| DOI: | 10.1093/eurheartj/ehz299 |
| ISSN: | 0195-668X |
| Publisher: | Oxford University Press (OUP) |
| Start Page: | 2801 |
| End Page: | 2809 |
| Journal / Book Title: | European Heart Journal |
| Volume: | 40 |
| Issue: | 33 |
| Copyright Statement: | © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
| Keywords: | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Alirocumab Prevention MI types Mortality UNIVERSAL DEFINITION METAANALYSIS CLASSIFICATION CHOLESTEROL EVOLOCUMAB THERAPY DISEASE Alirocumab MI types Mortality Prevention ODYSSEY OUTCOMES Investigators Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Alirocumab Prevention MI types Mortality UNIVERSAL DEFINITION METAANALYSIS CLASSIFICATION CHOLESTEROL EVOLOCUMAB THERAPY DISEASE 1102 Cardiorespiratory Medicine and Haematology 1103 Clinical Sciences Cardiovascular System & Hematology |
| Publication Status: | Published |
| Online Publication Date: | 2019-05-23 |
| Appears in Collections: | National Heart and Lung Institute |