Alirocumab in Patients With Polyvascular Disease and Recent Acute Coronary Syndrome

Jukema, J. Wouter; Szarek, Michael; Zijlstra, Laurien E.; Silva, H Asita de; Bhatt, Deepak L.; Bittner, Vera; Dı́az, Rafael; Edelberg, Jay M.; Goodman, Shaun G.; Hanotin, Corinne; Harrington, Robert A.; Karpov, Yuri; Moryusef, Angèle; Pordy, Robert; Prieto, Juan Carlos; Roe, Matthew T.; White, Harvey D.; Zeiher, Andreas M.; Schwartz, Gregory G.; Steg, Ph. Gabriel; Committees, Odyssey Outcomes; Investigators,

doi:10.1016/j.jacc.2019.03.013

Cited by 163 publications

(93 citation statements)

References 22 publications

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“…PCSK9 monoclonal antibodies have emerged as an alternative to LA in some patients with HeFH, polygenic and combined dyslipidaemias, which is reflected in our experience. This is now a common reason for discontinuation of LA and is likely to be both safe and effective, unless if the patient is known to be LDL receptor negative [25][26][27]. It seems likely that LA will remain an important intervention in HoFH and in patients with hyper Lp(a), although anti apo(a) antisense therapy, which is undergoing clinical trials may influence the latter, if proven to be effective.…”

Section: Discussionmentioning

confidence: 99%

Lipoprotein apheresis efficacy, challenges and outcomes: A descriptive analysis from the UK Lipoprotein Apheresis Registry, 1989–2017

et al. 2019

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Section: Discussionmentioning

confidence: 99%

Lipoprotein apheresis efficacy, challenges and outcomes: A descriptive analysis from the UK Lipoprotein Apheresis Registry, 1989–2017

et al. 2019

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“…The Odyssey Outcomes trial previously reported that alirocumab, a monoclonal antibody to proprotein convertase subtilisin-kexin type 9 (PCSK9), reduced risk of future CV events in patients with prior (1-12 months) ACS [45]. A new analysis from the trial suggests that patients with polyvascular disease benefit the most [46] with MACE in those with one, two or three diseased vascular beds being 10.0%, 22.2% and 39.7%, respectively. The corresponding absolute risk reductions with alirocumab were 1.4%, 1.9% and 13.0%, respectively (P = 0.0006 for interaction) suggesting that an aggressive approach to secondary prevention is particularly important in those with polyvascular disease.…”

Section: Lipidsmentioning

confidence: 99%

Advances in Clinical Cardiology 2019: A Summary of Key Clinical Trials

et al. 2020

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Introduction: A large number of important clinical trials in cardiology were published or presented at major international conferences during 2019. This paper aims to offer a concise overview of these significant advances and to put them into clinical context. Methods: Trials presented at the major international cardiology meetings during 2019 were reviewed including The American College of Cardiology (ACC), Euro PCR, The European Society of Cardiology (ESC), Transcatheter Cardiovascular Therapeutics (TCT), and the American Heart Association (AHA). In addition to this a literature search identified several other publications eligible for inclusion based on their relevance to clinical cardiology, their potential impact on clinical practice and on future guidelines. Results: A total of 70 trials met the inclusion criteria. New interventional and structural data include trials examining use of drug-coated balloons in patients with acute myocardial infarction (MI), interventions following Digital Features To view digital features for this article go to

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“…In prespecified subanalyses, higher-risk patients derived larger ARRs for MACE and mortality with alirocumab and lower NNT values ( Figure 2B). 76 These populations included patients with more recent ACS, baseline polyvascular disease 77 or prior CABG. 76 Higher disease severity, ie, increased number of diseased vascular beds or timing of CABG, led to larger ARRs for MACE and mortality with treatment ( Figure 2B).…”

Section: Odyssey Outcomes -Subanalyses In High-risk Patientsmentioning

confidence: 99%

<p>Cardiovascular Outcomes and Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors: Current Data and Future Prospects</p>

Duprez¹,

Handelsman²,

Koren³

2020

VHRM

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Cardiovascular (CV) disease remains the leading cause of morbidity and mortality worldwide and poses an ongoing challenge with the aging population. Elevated lowdensity lipoprotein cholesterol (LDL-C) is an established risk factor for atherosclerotic cardiovascular disease (ASCVD), and the expert consensus is the use of statin therapy (if tolerated) as first line for LDL-C reduction. However, patients with ASCVD may experience recurrent ischemic events despite receiving maximally tolerated statin therapy, including those whose on-treatment LDL-C remains ≥70 mg/dL, patients with familial hypercholesterolemia, high-risk subgroups with comorbidities such as diabetes mellitus, and those who have an intolerance to statin therapy. Optimal therapeutic strategies for this unmet need should deploy aggressive lipid lowering to minimize the contribution of dyslipidemia to their CV risk, particularly for very high-risk populations with additional risk factors beyond hypercholesterolemia and established ASCVD. To understand the current clinical climate and guidelines regarding ASCVD, we primarily searched PubMed for articles published in English regarding lipid-lowering therapies and CV risk reduction, including emerging therapies, and CV outcomes trials with proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. This review discusses the findings of recent clinical trial evidence for CV risk reduction with cholesterol-lowering therapies, with a focus on CV outcomes trials with PCSK9 inhibitors, and considers the impact of the study results for secondary prevention and future strategies in patients with hypercholesterolemia and CV risk despite maximally tolerated statin therapy.

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Alirocumab in Patients With Polyvascular Disease and Recent Acute Coronary Syndrome

Cited by 163 publications

References 22 publications

Lipoprotein apheresis efficacy, challenges and outcomes: A descriptive analysis from the UK Lipoprotein Apheresis Registry, 1989–2017

Lipoprotein apheresis efficacy, challenges and outcomes: A descriptive analysis from the UK Lipoprotein Apheresis Registry, 1989–2017

Advances in Clinical Cardiology 2019: A Summary of Key Clinical Trials

<p>Cardiovascular Outcomes and Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors: Current Data and Future Prospects</p>

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