Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial
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...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | artículo |
| Fecha de publicación: | 2019 |
| País: | España |
| Recursos: | Servizo Galego de Saúde (SERGAS) |
| Repositorio: | RUNA. Repositorio da Consellería de Sanidade e Sergas |
| OAI Identifier: | oai:runa.sergas.gal:20.500.11940/15753 |
| Acesso em linha: | https://www.ncbi.nlm.nih.gov/pubmed/31121022 http://hdl.handle.net/20.500.11940/15753 |
| Access Level: | acceso abierto |
| Palavra-chave: | Middle Aged Humans Antibodies Cholesterol Prospective Studies Aged Mortality Double-Blind Method Myocardial Infarction infarto de miocardio anciano mortalidad estudios prospectivos mediana edad humanos anticuerpos método con doble ocultación colesterol CHUS CHUVI HULA |
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Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trialWhite, H. D.Steg, P. G.Szarek, M.Bhatt, D. L.Bittner, V. A.Diaz, R.Edelberg, J. M.Erglis, A.Goodman, S. G.Hanotin, C.Harrington, R. A.Jukema, J. W.Lopes, R. D.Mahaffey, K. W.Moryusef, A.Pordy, R.Roe, M. T.Sritara, P.Tricoci, P.Zeiher, A. M.Schwartz, G. GIñiguez Romo, AndresGonzález Juanatey, José RamónGonzález Juanatey, CarlosMiddle AgedHumansAntibodiesCholesterolProspective StudiesAgedMortalityDouble-Blind MethodMyocardial Infarctioninfarto de miocardioancianomortalidadestudios prospectivosmediana edadhumanosanticuerposmétodo con doble ocultacióncolesterolCHUSCHUVIHULAAIMS: 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.ODYSSEY OUTCOMES Investigators2019info:eu-repo/semantics/articlehttps://www.ncbi.nlm.nih.gov/pubmed/31121022http://hdl.handle.net/20.500.11940/15753reponame:RUNA. Repositorio da Consellería de Sanidade e Sergasinstname:Servizo Galego de Saúde (SERGAS)Ingléshttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:runa.sergas.gal:20.500.11940/157532026-06-12T08:40:47Z |
| dc.title.none.fl_str_mv |
Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial |
| title |
Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial |
| spellingShingle |
Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial White, H. D. Middle Aged Humans Antibodies Cholesterol Prospective Studies Aged Mortality Double-Blind Method Myocardial Infarction infarto de miocardio anciano mortalidad estudios prospectivos mediana edad humanos anticuerpos método con doble ocultación colesterol CHUS CHUVI HULA |
| title_short |
Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial |
| title_full |
Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial |
| title_fullStr |
Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial |
| title_full_unstemmed |
Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial |
| title_sort |
Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial |
| dc.creator.none.fl_str_mv |
White, H. D. Steg, P. G. Szarek, M. Bhatt, D. L. Bittner, V. A. Diaz, R. Edelberg, J. M. Erglis, A. Goodman, S. G. Hanotin, C. Harrington, R. A. Jukema, J. W. Lopes, R. D. Mahaffey, K. W. Moryusef, A. Pordy, R. Roe, M. T. Sritara, P. Tricoci, P. Zeiher, A. M. Schwartz, G. G Iñiguez Romo, Andres González Juanatey, José Ramón González Juanatey, Carlos |
| author |
White, H. D. |
| author_facet |
White, H. D. Steg, P. G. Szarek, M. Bhatt, D. L. Bittner, V. A. Diaz, R. Edelberg, J. M. Erglis, A. Goodman, S. G. Hanotin, C. Harrington, R. A. Jukema, J. W. Lopes, R. D. Mahaffey, K. W. Moryusef, A. Pordy, R. Roe, M. T. Sritara, P. Tricoci, P. Zeiher, A. M. Schwartz, G. G Iñiguez Romo, Andres González Juanatey, José Ramón González Juanatey, Carlos |
| author_role |
author |
| author2 |
Steg, P. G. Szarek, M. Bhatt, D. L. Bittner, V. A. Diaz, R. Edelberg, J. M. Erglis, A. Goodman, S. G. Hanotin, C. Harrington, R. A. Jukema, J. W. Lopes, R. D. Mahaffey, K. W. Moryusef, A. Pordy, R. Roe, M. T. Sritara, P. Tricoci, P. Zeiher, A. M. Schwartz, G. G Iñiguez Romo, Andres González Juanatey, José Ramón González Juanatey, Carlos |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
ODYSSEY OUTCOMES Investigators |
| dc.subject.none.fl_str_mv |
Middle Aged Humans Antibodies Cholesterol Prospective Studies Aged Mortality Double-Blind Method Myocardial Infarction infarto de miocardio anciano mortalidad estudios prospectivos mediana edad humanos anticuerpos método con doble ocultación colesterol CHUS CHUVI HULA |
| topic |
Middle Aged Humans Antibodies Cholesterol Prospective Studies Aged Mortality Double-Blind Method Myocardial Infarction infarto de miocardio anciano mortalidad estudios prospectivos mediana edad humanos anticuerpos método con doble ocultación colesterol CHUS CHUVI HULA |
| description |
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. |
| publishDate |
2019 |
| dc.date.none.fl_str_mv |
2019 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
https://www.ncbi.nlm.nih.gov/pubmed/31121022 http://hdl.handle.net/20.500.11940/15753 |
| url |
https://www.ncbi.nlm.nih.gov/pubmed/31121022 http://hdl.handle.net/20.500.11940/15753 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.rights.none.fl_str_mv |
http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess |
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http://creativecommons.org/licenses/by-nc/4.0/ |
| eu_rights_str_mv |
openAccess |
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reponame:RUNA. Repositorio da Consellería de Sanidade e Sergas instname:Servizo Galego de Saúde (SERGAS) |
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Servizo Galego de Saúde (SERGAS) |
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RUNA. Repositorio da Consellería de Sanidade e Sergas |
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RUNA. Repositorio da Consellería de Sanidade e Sergas |
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