101. Effects of alirocumab on types of myocardial infarction : insights from the ODYSSEY OUTCOMES trial
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White, Harvey D., Steg, Ph. Gabriel, Harrington, Robert A., Endsley, Patricia, Gusi Tragant, Gabriel, Benedicto, Amparo, Gonzalez-Juanatey, Carlos, Camprubi Potau, Mercedes, Plaza Perez, Ignacio, Moris De La Tassa, Cesar, Loma-Osorio Rincon, Pablo, Balaguer Recena, Javier, M Escudier, Juan, Constantine, Godwin, Eppinger, Arleen, Haniffa, Ruvaiz, Tissera, Nirmali, Amarasekera, Stanley, Fernando, Nimali, Jayawardena, Jayanthimala, Santharaj, Wijeyasingam, Ekanayaka, Ruvan, Mendis, Sepalika, Senaratne, Vajira, Mayurathan, Gnanamoorthy, Hess, Connie Ng, Sirisena, Thilak, Rajapaksha, Ajantha, Herath, Jagath I., Amarasena, Naomali, Berglund, Stefan, Rasmanis, Gundars, Hagstrom, Emil, Witt, Nils, Mourtzinis, Georgios, Nicol, Peter, Hlatky, Mark A., Hansen, Ole, Romeo, Stefano, Jensen, Steen Agergaard, Torstensson, Ingemar, Ahremark, Ulf, Sundelin, Torbjorn, Moccetti, Tiziano, Mueller, Christian, Mach, Francois, Jordan, Joseph Dedrick, Binder, Ronald, Chiang, Chern-En, Tsai, Wei-Chuan, Ueng, Kwo-Chang, Lai, Wen-Ter, Liu, Ming-En, Hwang, Juey-Jen, Yin, Wei-Hsian, Hsieh, I. Chang, Lin, Wei Hsiang, Knowles, Joshua W., Kuo, Jen-Yuan, Huang, Tsuei-Yuan, Fang, Chih-Yuan, Kaewsuwanna, Pinij, Soonfuang, Wasant, Jintapakorn, Woravut, Sukonthasarn, Apichard, Sritara, Piyamitr, Wongpraparut, Nattawut, Sastravaha, Krisada, Kolls, Bradley J., Sansanayudh, Nakarin, Kehasukcharoen, Wirash, Piyayotai, Dilok, Camsari, Ahmet, Kultursay, Hakan, Guneri, Sema, Mutlu, Bulent, Ersanli, Murat, Demirtas, Mustafa, Kirma, Cevat, Kong, David F., Ural, Ertan, Koldas, Lale, Karpenko, Oleksandr, Prokhorov, Alexander, Vakaluyk, Ihor, Myshanych, Halyna, Reshotko, Dmytro, Batushkin, Valeriy, Rudenko, Leonid, Kovalskyi, Ihor, Leonardi, Sergio, Kushnir, Mykola, Tseluyko, Vira, Mostovoy, Yuriy, Stanislavchuk, Mykola, Kyiak, Yulian, Karpenko, Yuriy, Malynovsky, Yaroslav, Klantsa, Andriy, Kutniy, Oles, Amosova, Ekaterina, Lillis, Linda, Tashchuk, Viktor, Leshchuk, Oleh, Parkhomenko, Alexander, Rishko, Mykola, Kopytsya, Mykola, Yagensky, Andriy, Vatutin, Mykola, Bagriy, Andriy, Barna, Olga M., Ushakov, Olexiy, Jukema, J. Wouter, Lopes, Renato D., Dzyak, Georgiy, Goloborodko, Borys, Rudenko, Anatolii, Trevelyan, Jasper, Zaman, Azfar, Lee, Kaeng, Moriarty, Andrew, Aggarwal, Rajesh K., Clifford, Piers, Wong, Yuk-Ki, Maron, David J., Iqbal, Syed M. R., Subkovas, Eduardas, Braganza, Denise, Sarkar, David, Storey, Robert, Griffiths, Huw, Mcclure, Sam, Muthusamy, Rangasamy, Kurian, John, Levy, Terry, Marcus, Jill, Barr, Craig, Kadr, Honer, Gerber, Robert, Simaitis, Audrius, Soran, Handrean, Mathur, Anthony, Brodison, Adrian, Oliver, Richard, Mudawi, Telal, Reynolds, Timothy, Mathews, Robin, Sharman, David, Butler, Rob, Wilkinson, Peter, Lip, Gregory Y. 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W., Turi, Tibor, Merkely, Bela, Alings, Marco, Ungi, Imre, Lupkovics, Geza, Nagy, Lajos, Katona, Andras, Edes, Istvan, Muller, Gabor, Horvath, Ivan, Kapin, Tibor, Falukozy, Jozsef, Halvorsen, Sigrun, Kumbla, Mukund, Sandhu, Manjinder, Annam, Sharath, Proddutur, Naveen Reddy, Premchand, Rajendra K., Mahajan, Ajaykumar, Abhyanakar, Atul D., Kerkar, Prafulla, Govinda, Ravishankar A., Oomman, Abraham, Correa Flores, Roger M., Sinha, Dhurjati, Patil, Sachin N., Kahali, Dhiman, Sawhney, Jitendra, Joshi, Abhijeet B., Chaudhary, Sanjeev, Harkut, Pankaj, Guha, Santanu, Porwal, Sanjay, Jujjuru, Srimannarayana, Sy, Rody G., Pothineni, Ramesh B., Monteiro, Minguel R., Khan, Aziz, Iyengar, Shamanna S., Grewal, Jasprakash Singh, Chopda, Manoj, Fulwani, Mahesh C., Patange, Aparna, Chopra, Vijay K., Goyal, Naresh K., Budaj, Andrzej, Shinde, Rituparna, Manakshe, Gajendra V., Patki, Nitin, Sethi, Sumeet, Munusamy, Vengatesh, Karna, Sunil, Adhyapak, Srilakshmi, Pandurangi, Ulhas, Mathur, Rishabh, Kalashetti, Suhas, Edelberg, Jay M., Morais, Joao, Bhagwat, Ajit, Raghuraman, Bagirath, Yerra, Shiv Kumar, Bhansali, Prasant, Borse, Rohidas, Das, Srihari, Abdullakutty, Jabir, Saathe, Shireesh, Palimkar, Priya, Atar, Shaul, Dorobantu, Maria, Shechter, Michael, Mosseri, Morris, Arbel, Yaron, Lotan, Chaim, Rosenschein, Uri, Katz, Amos, Henkin, Yaakov, Francis, Adi, Klutstein, Marc, Nikolsky, Eugenia, Karpov, Yuri, Turgeman, Yoav, Halabi, Majdi, Kornowski, Ran, Jonas, Michael, Amir, Offer, Rozenman, Yoseph, Fuchs, Shmuel, Hussein, Osamah, Gavish, Dov, Vered, Zvi, Ristic, Arsen D., Caraco, Yoseph, Elias, Mazen, Tov, Naveh, Piovaccari, Giancarlo, De Pellegrin, Annamaria, Guardigli, Gabriele, Licciardello, Giovanni, Auguadro, Carla, Cuccia, Claudio, Salvioni, Alessandro, Chua, Terrance, Musumeci, Giuseppe, Calabro, Paolo, Novo, Salvatore, Faggiano, Pompilio, De Cesare, Nicoletta B., Berti, Sergio, Cavallini, Claudio, Puccioni, Enrico, Galvani, Marcello, Tespili, Maurizio, Murin, Jan, Piatti, Piermarco, Palvarini, Michela, De Luca, Giuseppe, Violini, Roberto, De Leo, Alessandro, Filardi, Pasquale Perrone, Ferratini, Maurizio, Dai, Kazuoki, Kamiya, Haruo, Ando, Kenji, Fras, Zlatko, Takeda, Yoshihiro, Morino, Yoshihiro, Hata, Yoshiki, Kimura, Kazuo, Kishi, Koichi, Michishita, Ichiro, Uehara, Hiroki, Higashikata, Toshinori, Hirayama, Atsushi, Hirooka, Keiji, Dalby, Anthony J., Sakagami, Satoru, Taguchi, Shuichi, Koike, Akihiro, Fujinaga, Hiroyuki, Koba, Shinji, Kozuma, Ken, Kawasaki, Tomohiro, Ono, Yujiro, Shimizu, Masatoshi, Katsuda, Yousuke, Tunon, Jose, Wada, Atsuyuki, Shinke, Toshiro, Ako, Junya, Fujii, Kenshi, Takahashi, Toshiyuki, Sakamoto, Tomohiro, Furukawa, Yutaka, Sugino, Hiroshi, Mano, Toshiaki, Utsu, Noriaki, de Silva, H. 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M., Suryapranata, Harry, Oomen, Antonius, Wiersma, Jacobijne J., Van Der Wal, Ruud M. A., Van Huysduynen-Monraats, Pascalle S. Hooft, Karalis, Ioannis, Verdel, Gerardus J. E., Brueren, Bart R. G., Troquay, Roland P. Th, Viergever, Eric P., Al-Windy, Nadea Y. Y., Bartels, Gerard L., Ray, Kausik K., Cornel, Jan H., Hermans, Walter R. M., Herrman, Johannes P. R., Bos, Robert J., Groutars, Reginald G. E. J., Van Der Zwaan, Coenraad C., Kaplan, Refik, Ronner, Eelko, Groenemeijer, Bjorn E., Bronzwaer, Patrick N. A., Liem, Anho A. H., Rensing, Bernard J. W. M., Bokern, Marcel J. J. A., Nijmeijer, Remco, Hersbach, Ferry M. R. J., Willems, Frank F., Gosselink, Antonius T. M., Elliott, John, Wilkins, Gerard, Fisher, Raewyn, Vogel, Robert, Scott, Douglas, Hart, Hamish, Stewart, Ralph, Harding, Scott, Ternouth, Ian, Fisher, Nicholas, Aitken, Denise, Anscombe, Russell, Tomala, Tadeusz, Nygard, Ottar, Chaitman, Bernard, Sparby, Jon Arne, Andersen, Kjell, Gullestad, Lars, Jortveit, Jarle, Munk, Peter S., Hurtig, Ulf, Ticona, Jorge R. Calderon, Velasquez, Julio R. Durand, Miguel, Sandra A. Negron, Perez, Enrique S. Sanabria, Kelsey, Sheryl F., Chambilla, Jesus M. Carrion, Ayala, Carlos A. Chavez, Leon, Reynaldo P. Castillo, Gonzales, Rolando J. Vargas, Zuniga, Jose D. Hernandez, Cosavalente, Luis A. Camacho, Mannucci, Jorge E. Bravo, Navarro, Nassip C. Llerena, Concha, Yudy M. Roldan, Chavez, Victor E. Rodriguez, Olsson, Anders G., Hernandez, Henry A. Anchante, Nunez, Carlos A. Zea, Ferrolino, Arthur, Sy, Rosa Allyn G., Tirador, Louie, Matiga, Generoso, Coching, Raul Martin, Bernan, Alisa, Rogelio, Gregorio, Morales, Dante D., Rouleau, Jean-Lucien, Tan, Edgar, Wlodarczak, Adrian, Jaworska, Krystyna, Skonieczny, Grzegorz, Pawlowicz, Lidia, Wojewoda, Pawel, Busz-Papiez, Benita, Bednarski, Janusz, Goch, Aleksander, Staneta, Pawel, Simoons, Maarten L., Dulak, Elzbieta, Saminski, Krzysztof, Krasowski, Wlodzimierz, Sudnik, Wanda, Zurakowski, Aleksander, Skorski, Marcin, Lysek, Roman, Miklaszewicz, Beata, Kubica, Jacek, Lipko, Jan Andrzej, Alexander, Karen, Kostarska-Srokosz, Edyta, Piepiorka, Marek, Drzewiecka, Anna, Sciborski, Ryszard, Stasiewski, Arkadiusz, Blicharski, Tomasz, Bystryk, Leszek, Szpajer, Michal, Korol, Marek, Czerski, Tomasz, Meloni, Chiara, Mirek-Bryniarska, Ewa, Gniot, Jacek, Lubinski, Andrzej, Gorny, Jerzy, Franek, Edward, Monteiro, Pedro, Bastos, Jose Mesquita, Pereira, Helder H., Martins, Dinis, Seixo, Filipe, Rosenson, Robert, Mendonca, Carlos, Botelho, Ana, Minescu, Bogdan, Istratoaie, Octavian, Tesloianu, Dan N., Cristian, Gabriel, Podoleanu, Cristian G. C., Constantinescu, Mircea C. A., Bengus, Cristina M., Militaru, Constantin, Sijbrands, Eric J. G., Rosu, Doina, Parepa, Irinel R., Matei, Adrian V., Alexandru, Tom M., Shvarts, Yury, Orlikova, Olga, Kobalava, Zhanna, Barbarash, Olga L., Markov, Valentin, Lyamina, Nadezhda, Alexander, John H., Gordienko, Alexander, Zrazhevsky, Konstantin, Vishnevsky, Alexander Y., Gurevich, Victor, Stryuk, Raisa, Lomakin, Nikita V., Bokarev, Igor, Shalaev, Sergey, Khaisheva, Larisa, Chizhov, Petr, Armaganijan, Luciana, Viktorova, Inna, Osokina, Natalya, Akatova, Evgenia, Chumakova, Galina, Libov, Igor, Voevoda, Mikhail I., Tretyakova, Tatyana V., Baranov, Evgeny, Shustov, Sergey, Yakushin, Sergey, Hanotin, Corinne, Bagai, Akshay, Gordeev, Ivan, Khasanov, Niiaz, Reshetko, Olga, Sotnikova, Tatiana, Molchanova, Olga, Nikolaev, Konstantin, Gapon, Liudmila, Baranova, Elena, Shogenov, Zaur, Kosmachova, Elena, Bahit, Maria Cecilia, Karpov, Yuriy, Povzun, Anton, Egorova, Liudmila, Tyrenko, Vadim V., Ivanov, Igor G., Simic, Dragan, Ivanovic, Nikola, Davidovic, Goran, Tasic, Nebojsa, Asanin, Milika R., Brennan, J. Matthew, Stojic, Stevo, Apostolovic, Svetlana R., Ilic, Stevan, Putnikovic, Biljana, Stankovic, Aleksandar, Arandjelovic, Aleksandra, Radovanovic, Slavica, Balinovac, Jovan, Dincic, Dragan V., Seferovic, Petar, Clifton, Shaun, Dodic, Slobodan, Dimkovic, Sinisa, Poh, Kian-Keong, Ong, Hean Yee, Micko, Karol, Nociar, Jan, Pella, Daniel, Fulop, Peter, Hranai, Marian, Palka, Juraj, DeVore, Adam D., Mazur, Juraj, Majercak, Ivan, Dzupina, Andrej, Fazekas, Frantisek, Gonsorcik, Jozef, Bugan, Viliam, Selecky, Juraj, Kamensky, Gabriel, Strbova, Jaroslava, Smik, Rudolf, Deloatch, Shalonda, Dukat, Andrej, Zuran, Ivan, Oklukar, Janez, Suligoj, Natasa Cernic, Cevc, Matija, Lipar, Luka, Cyster, Henry P., Ranjith, Naresh, Corbett, Clive, Bayat, Junaid, Dickey, Sheila, Makotoko, Ellen Makoali, Kapp, Ilse E., Basson, Matthys M. de V., Lottering, Hanlie, Van Zyl, Louis J., Sebastian, Peter J., Pillay, Thayabran, Saaiman, Jan A., Commerford, Patrick J., Cassimjee, Soraya, Dombrowski, Keith, Ebrahim, Iftikhar O., Sarvan, Mahomed, Mynhardt, Joseph H., Reuter, Helmuth, Moodley, Rajendran, Vida, Manuel, Cequier Fillat, Angel R., Bodi Peris, Vicente, Fuentes Jimenez, Francisco, Ducrocq, Gregory, Marin, Francisco, Cruz Fernandez, Jose M., Gil-Extremera, Blas, Worner Diz, Fernando, Garcia-Dorado, David, Iniguez, Andres, Tunon Fernandez, Jose, Gonzalez-Juanatey, Jose R., Fernandez Portales, Javier, Civeira Murillo, Fernando, Eapen, Zubin, Matas Pericas, Laia, Luis Zamorano, Jose, De Mora Martin, Manuel, Bruguera Cortada, Jordi, Alonso Martin, Joaquin J., De Berrazueta Fernandez, Jose R., Diaz Fernandez, Jose Francisco, Garcia Lledo, Jose Alberto, Cosin Sales, Juan, Botas Rodriguez, Javier, Sinnaeve, Peter, İÜC, Ege Üniversitesi, Cardiology, Internal Medicine, and ODYSSEY OUTCOMES Investigators
- Subjects
Male ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences ,Cardiac & Cardiovascular Systems ,Myocardial Infarction ,UNIVERSAL DEFINITION ,030204 cardiovascular system & hematology ,THERAPY ,DISEASE ,chemistry.chemical_compound ,0302 clinical medicine ,Cardiac and Cardiovascular Systems ,030212 general & internal medicine ,Myocardial infarction ,Prospective Studies ,1102 Cardiorespiratory Medicine and Haematology ,Oxygen supply ,Kardiologi ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti ,CHOLESTEROL ,Middle Aged ,MI types ,Cardiology ,LDL Cholesterol Lipoproteins ,Female ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,medicine.medical_specialty ,ODYSSEY OUTCOMES Investigators ,Antibodies, Monoclonal, Humanized ,CLASSIFICATION ,03 medical and health sciences ,Double-Blind Method ,Internal medicine ,medicine ,Humans ,ddc:610 ,Alirocumab ,Mortality ,Prevention ,METAANALYSIS ,Aged ,Science & Technology ,Task force ,Cholesterol ,business.industry ,EVOLOCUMAB ,1103 Clinical Sciences ,Cholesterol, LDL ,medicine.disease ,Evolocumab ,chemistry ,Cardiovascular System & Hematology ,Cardiovascular System & Cardiology ,Human medicine ,business - Abstract
Gislason, Gunnar H/0000-0002-0548-402X; Malynovsky, Yaroslav V/0000-0002-9118-1104; Bhatt, Deepak L./0000-0002-1278-6245; Nikolaev, Konstantin/0000-0003-4601-6203; Sherwood, Matthew/0000-0002-4305-5883; Chumakova, Galina A/0000-0002-2810-6531; Raffel, Owen C/0000-0001-5470-7050; Leonardi, Sergio/0000-0002-4800-6132; Tse, Hung Fat/0000-0002-9578-7808; Reshetko, Olga/0000-0003-3107-7636; Pereira, Helder/0000-0001-8656-4883; Racca, Vittorio/0000-0002-4465-3789; Podoleanu, Cristian/0000-0001-9987-2519; Ersanli, Murat/0000-0003-1847-3087; Muenzel, Thomas/0000-0001-5503-4150; Sandhu, Manjinder/0000-0003-2538-2079; Taskinen, Marja-Riitta/0000-0002-6229-3588; bastos, jose/0000-0002-9526-3123; Manakshe, Gajendra/0000-0002-4983-4271; Abbate, Antonio/0000-0002-1930-785X; STEG, Philippe Gabriel/0000-0001-6896-2941; Szarek, Michael/0000-0002-0046-0264; Bittner, Vera/0000-0001-9456-850X; Goodman, Shaun/0000-0001-8068-2440, WOS: 000490154300015, PubMed: 31121022, 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., Sanofi; Regeneron Pharmaceuticals, Supported by Sanofi and Regeneron Pharmaceuticals.
- Published
- 2019