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Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

dc.contributor.authorWhite, H. D.
dc.contributor.authorSteg, P. G.
dc.contributor.authorSzarek, M.
dc.contributor.authorBhatt, D. L.
dc.contributor.authorBittner, V. A.
dc.contributor.authorDiaz, R.
dc.contributor.authorEdelberg, J. M.
dc.contributor.authorErglis, A.
dc.contributor.authorGoodman, S. G.
dc.contributor.authorHanotin, C.
dc.contributor.authorHarrington, R. A.
dc.contributor.authorJukema, J. W.
dc.contributor.authorLopes, R. D.
dc.contributor.authorMahaffey, K. W.
dc.contributor.authorMoryusef, A.
dc.contributor.authorPordy, R.
dc.contributor.authorRoe, M. T.
dc.contributor.authorSritara, P.
dc.contributor.authorTricoci, P.
dc.contributor.authorZeiher, A. M.
dc.contributor.authorSchwartz, G. G
dc.contributor.authorIñiguez Romo, Andres 
dc.contributor.authorGonzález Juanatey, José Ramón 
dc.contributor.authorGonzález Juanatey, Carlos 
dc.date.accessioned2021-11-29T13:29:09Z
dc.date.available2021-11-29T13:29:09Z
dc.date.issued2019
dc.identifier.issn0195-668X
dc.identifier.otherhttps://www.ncbi.nlm.nih.gov/pubmed/31121022es
dc.identifier.urihttp://hdl.handle.net/20.500.11940/15753
dc.description.abstractAIMS: 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.en
dc.language.isoenges
dc.rightsAtribución-NoComercial 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.subject.meshMiddle Aged*
dc.subject.meshHumans*
dc.subject.meshAntibodies*
dc.subject.meshCholesterol*
dc.subject.meshProspective Studies*
dc.subject.meshAged*
dc.subject.meshMortality*
dc.subject.meshDouble-Blind Method*
dc.subject.meshMyocardial Infarction*
dc.titleEffects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trialen
dc.typeArtigoes
dc.contributor.authorcorpODYSSEY OUTCOMES Investigators
dc.authorsophosWhite, H. D.
dc.authorsophosSteg, P. G.
dc.authorsophosSzarek, M.
dc.authorsophosBhatt, D. L.
dc.authorsophosBittner, V. A.
dc.authorsophosDiaz, R.
dc.authorsophosEdelberg, J. M.
dc.authorsophosErglis, A.
dc.authorsophosGoodman, S. G.
dc.authorsophosHanotin, C.
dc.authorsophosHarrington, R. A.
dc.authorsophosJukema, J. W.
dc.authorsophosLopes, R. D.
dc.authorsophosMahaffey, K. W.
dc.authorsophosMoryusef, A.
dc.authorsophosPordy, R.
dc.authorsophosRoe, M. T.
dc.authorsophosSritara, P.
dc.authorsophosTricoci, P.
dc.authorsophosZeiher, A. M.
dc.authorsophosSchwartz, G. G.
dc.authorsophosAylward, P. E.
dc.authorsophosDrexel, H.
dc.authorsophosSinnaeve, P.
dc.authorsophosDilic, M.
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dc.authorsophosMacdonell, A.
dc.authorsophosGibson, P.
dc.authorsophosRahman, A.
dc.authorsophosAl Joundi, T.
dc.authorsophosConrad, G.
dc.authorsophosKotha, P.
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dc.authorsophosGilmore, R.
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dc.authorsophosGardner, G.
dc.authorsophosDandillaya, R.
dc.authorsophosVora, K.
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dc.authorsophosInvestigators, Odyssey Outcomes
dc.identifier.doi10.1093/eurheartj/ehz299
dc.identifier.pmid31121022
dc.identifier.sophos31573
dc.issue.number33es
dc.journal.titleEuropean Heart Journales
dc.organizationServizo Galego de Saúde::Estrutura de Xestión Integrada (EOXI)::EOXI de Santiago de Compostela - Complexo Hospitalario Universitario de Santiago de Compostela::Cardioloxíaes
dc.organizationServizo Galego de Saúde::Estrutura de Xestión Integrada (EOXI)::EOXI de Vigo - Complexo Hospitalario Universitario de Vigo::Cardioloxíaes
dc.organizationServizo Galego de Saúde::Estrutura de Xestión Integrada (EOXI)::EOXI de Lugo, Cervo e Monforte de lemos - Complexo Hospitalario Universitario Lucus Augusti::Cardioloxíaes
dc.page.initial2801es
dc.page.final2809es
dc.rights.accessRightsopenAccesses
dc.subject.decsinfarto de miocardio*
dc.subject.decsanciano*
dc.subject.decsmortalidad*
dc.subject.decsestudios prospectivos*
dc.subject.decsmediana edad*
dc.subject.decshumanos*
dc.subject.decsanticuerpos*
dc.subject.decsmétodo con doble ocultación*
dc.subject.decscolesterol*
dc.subject.keywordCHUSes
dc.subject.keywordCHUVIes
dc.subject.keywordHULAes
dc.typefidesArtículo Originales
dc.typesophosArtículo Originales
dc.volume.number40es


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Eur Heart J. 2019 Sep 1;40(33):2801-2809

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