Alirocumab and Cardiovascular Outcomes in Patients With Previous Myocardial Infarction: Prespecified Subanalysis From ODYSSEY OUTCOMES

Chiang, Chern‐En; Schwartz, Gregory G.; Elbez, Yedid; Szarek, Michael; Bhatt, Deepak L.; Bittner, Vera; Dı́az, Rafael; Ērglis, Andrejs; Goodman, Shaun G.; Hagström, Emil; Jukema, J. Wouter; Liberopoulos, Evangelos; Loy, Megan; Pordy, Robert; White, Harvey D.; Simon, Tabassome; Steg, Philippe Gabríel

doi:10.1016/j.cjca.2022.05.021

Cited by 10 publications

(4 citation statements)

References 25 publications

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“…The risk of ischemic stroke was significantly reduced by evolocumab (1.2 vs. 1.6%), in subgroup analyses of patients with prior ischemic stroke vs. patients without [76]. In the ODYSSEY OUTCOMES subanalysis, the estimated absolute risk reductions with alirocumab were numerically greater in patients with previous MI (MACE, 1.91% vs. 1.42%; death, 1.35% vs. 0.41%) [77]. A further post hoc analysis evaluating the efficacy of alirocumab according to metabolic risk factors concluded consistently reduced MACE across categories defined by the number of metabolic risk factors, but absolute risk reduction (aRR) increased with the number of metabolic risk factors findings revealed larger aRR in cardiovascular events compared to individuals without diabetes (7.7-14.6%) and metabolic syndrome (0.91 to 3.82%) [78].…”

Section: Pcsk9 Inhibitors and Cardiovascular Outcomesmentioning

confidence: 90%

PCSK9 and Lipid Metabolism: Genetic Variants, Current Therapies, and Cardiovascular Outcomes

Grejtakova,

Boronova,

Bernasovska

et al. 2024

Cardiovasc Drugs Ther

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Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a crucial role in the modulation of lipid metabolism as a critical negative regulator of hepatic low-density lipoprotein receptor (LDLR) levels and circulating low-density lipoprotein (LDL) clearance. Numerous gain-of-function (GOF) mutations in PCSK9 have been identified as causing familial hypercholesterolemia (FH) by reducing LDLR levels, and loss-of-function (LOF) mutations associated with a hypercholesterolemia phenotype protective against atherosclerosis. PCSK9 represents an example of successful translational research resulting in the identification of PCSK9 as a major drug target for a lipid-lowering therapy. To explore the genetic constitution of PCSK9 and its biologic role, in this review, we summarize the current evidence of clinically significant PCSK9 genetic variants involved in lipid metabolism as well as emphasize the importance of PCSK9 inhibition for the improvement of cardiovascular outcomes by conducting a meta-analysis of the available data on the incidence of cardiovascular disease events.

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Section: Pcsk9 Inhibitors and Cardiovascular Outcomesmentioning

confidence: 90%

PCSK9 and Lipid Metabolism: Genetic Variants, Current Therapies, and Cardiovascular Outcomes

Grejtakova,

Boronova,

Bernasovska

et al. 2024

Cardiovasc Drugs Ther

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show abstract

“…[ 30 ] concluded that patients with a history of CAD are at higher risk despite normal myocardial perfusion. Numerous studies have shown that patients with prior MI experienced a higher risk of MACE or cardiovascular events and history of CAD may be especially important for risk stratification [ 31 , 32 , 33 ]. In this study, previous MI was a stronger risk factor to predict TVR, consistent with previous investigations.…”

Section: Discussionmentioning

confidence: 99%

A Visualized Nomogram for Predicting Prognosis in Elderly Patients after Percutaneous Coronary Intervention

Chen,

Hong

et al. 2024

Rev. Cardiovasc. Med.

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Background: Revascularized patients still experience adverse cardiovascular events. This is particularly true for elderly patients over the age of 65, as they often have more co-morbid vascular conditions. It is important to develop a tool to assist clinicians in comprehensively assessing these patients’ prognosis. The objective of this study is to create a comprehensive visual nomogram model combining clinical and physiological assessments to predict outcomes in elderly patients undergoing percutaneous coronary intervention (PCI). Methods: This study is a retrospective investigation of patients who underwent PCI between January 2016 and December 2017. A total of 691 patients with 1461 vessels were randomly divided into a training (n = 483) and a validation set (n = 208). A multivariate Cox regression model was employed using the training set to select variables for constructing a nomogram. The performance of the nomogram was assessed through the receiver operating characteristic curve (ROC) and calibration curves to evaluate its discrimination and predictive accuracy. To further assess the clinical usefulness, Kaplan–Meier curve analysis and landmark analysis were conducted. Results: Independent risk factors, including diabetes mellitus (DM), post-PCI quantitative flow ratio (QFR), previous myocardial infarction (MI), and previous PCI, were contained in the nomogram. The nomogram exhibited a good area under the curve (AUC) ranging from 0.742 to 0.789 in the training set, 0.783 to 0.837 in the validation set, and 0.764 to 0.786 in the entire population. Calibration curves demonstrated a well-fitted curve in all three sets. The Kaplan–Meier curves showed clear separation and the patients with higher scores in the nomogram model exhibited a higher incidence of target vessel revascularization (TVR) (7.99% vs. 1.24% for 2-year, p 0.001 and 13.54% vs. 2.23% for 5-years, p 0.001, respectively). Conclusions: This study has developed the visually intuitive nomogram to predict the 2-year and 5-year TVR rates for elderly patients who underwent PCI. This tool provides more accurate and comprehensive healthcare guidance for patients and their physicians.

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“…Both drugs described, are also effective in the treatment of familial hypercholesterolemia, especially in terms of beneficial effects on the vascular endothelium [17] [18]. Compared to placebo, the 4-year risk of adverse cardiovascular events (MACE) and death was lower with alirocumab [19]. More than one year of alirocumab therapy significantly regresses coronary lesions and improves their hemodynamics compared to placebo [20].…”

Section: Monoclonal Antibodies Blocking Pcsk9 Actionmentioning

confidence: 99%

New drugs for the treatment of hyperlipidemia in statin-intolerant patients - review

Płonka,

Pelc,

Sitarek

et al. 2024

J Educ Health Sport

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Introduction Cardiovascular diseases are the most numerous group of diseases prevalent in the world. They are a challenge for many health systems, in terms of keeping life comfortable and also economics. The cause of selected disease entities is too much cholesterol in the blood. The most popular treatment for hypercholesterolemia is based on statins. Many patients are affected by intolerance to these drugs, so an important issue is the discovery and improvement of alternatives to statins. Purpose of work The purpose of this review is to collect literature data on the latest treatments for hypercholesterolemia with drugs other than statins and ezetimibe. Materials and methods Materials are from a review of recent literature available in PubMed. To search for articles, we used keywords such as: bempedoic acid, non-statin therapy, cardiovascular risk, inclisiran, alirocumab, cardiovascular disease, dyslipidemia, evolocumab. Summary Treatment of hypercholesterolemia with statins remains the most popular management strategy. Intolerance to treatment with these drugs creates serious clinical problems for patients. Recently, we could see the emergence of new drugs as alternatives to statins. As the results show, the new drugs can effectively replace statins in the hypolipemic treatment especially of patients who cannot be treated with them.

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Alirocumab and Cardiovascular Outcomes in Patients With Previous Myocardial Infarction: Prespecified Subanalysis From ODYSSEY OUTCOMES

Cited by 10 publications

References 25 publications

PCSK9 and Lipid Metabolism: Genetic Variants, Current Therapies, and Cardiovascular Outcomes

PCSK9 and Lipid Metabolism: Genetic Variants, Current Therapies, and Cardiovascular Outcomes

A Visualized Nomogram for Predicting Prognosis in Elderly Patients after Percutaneous Coronary Intervention

New drugs for the treatment of hyperlipidemia in statin-intolerant patients - review

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