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@article{Szarek:2020:eurheartj/ehaa649,
author = {Szarek, M and Bittner, VA and Aylward, P and Baccara-Dinet, M and Bhatt, DL and Diaz, R and Fras, Z and Goodman, SG and Halvorsen, S and Harrington, RA and Jukema, JW and Moriarty, PM and Pordy, R and Ray, KK and Sinnaeve, P and Tsimikas, S and Vogel, R and White, HD and Zahger, D and Zeiher, AM and Steg, PG and Schwartz, GG and ODYSSEY, OUTCOMES Investigators},
doi = {eurheartj/ehaa649},
journal = {European Heart Journal},
pages = {4245--4255},
title = {Lipoprotein(a) lowering by alirocumab reduces the total burden of cardiovascular events independent of low-density lipoprotein cholesterol lowering: ODYSSEY OUTCOMES trial},
url = {http://dx.doi.org/10.1093/eurheartj/ehaa649},
volume = {41},
year = {2020}
}

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TY  - JOUR
AB  - AIMS: Lipoprotein(a) concentration is associated with first cardiovascular events in clinical trials. It is unknown if this relationship holds for total (first and subsequent) events. In the ODYSSEY OUTCOMES trial in patients with recent acute coronary syndrome (ACS), the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab reduced lipoprotein(a), low-density lipoprotein cholesterol (LDL-C), and cardiovascular events compared with placebo. This post hoc analysis determined whether baseline levels and alirocumab-induced changes in lipoprotein(a) and LDL-C [corrected for lipoprotein(a) cholesterol] independently predicted total cardiovascular events. METHODS AND RESULTS: Cardiovascular events included cardiovascular death, non-fatal myocardial infarction, stroke, hospitalization for unstable angina or heart failure, ischaemia-driven coronary revascularization, peripheral artery disease events, and venous thromboembolism. Proportional hazards models estimated relationships between baseline lipoprotein(a) and total cardiovascular events in the placebo group, effects of alirocumab treatment on total cardiovascular events by baseline lipoprotein(a), and relationships between lipoprotein(a) reduction with alirocumab and subsequent risk of total cardiovascular events. Baseline lipoprotein(a) predicted total cardiovascular events with placebo, while higher baseline lipoprotein(a) levels were associated with greater reduction in total cardiovascular events with alirocumab (hazard ratio Ptrend = 0.045). Alirocumab-induced reductions in lipoprotein(a) (median -5.0 [-13.6, 0] mg/dL) and corrected LDL-C (median -51.3 [-67.1, -34.0] mg/dL) independently predicted lower risk of total cardiovascular events. Each 5-mg/dL reduction in lipoprotein(a) predicted a 2.5% relative reduction in cardiovascular events. CONCLUSION: Baseline lipoprotein(a) predicted the risk of total cardiovascular events and risk reduction by alirocumab. Lipoprotein(a) lowering contributed indepen
AU  - Szarek,M
AU  - Bittner,VA
AU  - Aylward,P
AU  - Baccara-Dinet,M
AU  - Bhatt,DL
AU  - Diaz,R
AU  - Fras,Z
AU  - Goodman,SG
AU  - Halvorsen,S
AU  - Harrington,RA
AU  - Jukema,JW
AU  - Moriarty,PM
AU  - Pordy,R
AU  - Ray,KK
AU  - Sinnaeve,P
AU  - Tsimikas,S
AU  - Vogel,R
AU  - White,HD
AU  - Zahger,D
AU  - Zeiher,AM
AU  - Steg,PG
AU  - Schwartz,GG
AU  - ODYSSEY,OUTCOMES Investigators
DO  - eurheartj/ehaa649
EP  - 4255
PY  - 2020///
SN  - 0195-668X
SP  - 4245
TI  - Lipoprotein(a) lowering by alirocumab reduces the total burden of cardiovascular events independent of low-density lipoprotein cholesterol lowering: ODYSSEY OUTCOMES trial
T2  - European Heart Journal
UR  - http://dx.doi.org/10.1093/eurheartj/ehaa649
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33051646
UR  - http://hdl.handle.net/10044/1/84196
VL  - 41
ER  -

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