Publicación:
Risk Categorization Using New American College of Cardiology/American Heart Association Guidelines for Cholesterol Management and Its Relation to Alirocumab Treatment Following Acute Coronary Syndromes

Página de artículo simple
dc.contributor.authorRoe, Matthew T.
dc.contributor.authorLi, Qian H.
dc.contributor.authorBhatt, Deepak L.
dc.contributor.authorBittner, Vera A.
dc.contributor.authorDiaz, Rafael
dc.contributor.authorGoodman, Shaun G.
dc.contributor.authorHarrington, Robert A.
dc.contributor.authorJukema, J. Wouter
dc.contributor.authorLopez-Jaramillo, Patricio
dc.contributor.authorLopes, Renato D.
dc.contributor.authorLouie, Michael J.
dc.contributor.authorMoriarty, Patrick M.
dc.contributor.authorSzarek, Michael
dc.contributor.authorVogel, Robert
dc.contributor.authorWhite, Harvey D.
dc.contributor.authorZeiher, Andreas M.
dc.contributor.authorBaccara-Dinet, Marie T.
dc.contributor.authorSteg, Gabriel
dc.contributor.authorSchwartz, Gregory G.
dc.contributor.researchgroupEverestspa
dc.date.accessioned2021-11-18T12:44:50Z
dc.date.available2021-11-18T12:44:50Z
dc.date.issued2019-11-05
dc.descriptionDigitalspa
dc.description.abstractBackground: The 2018 US cholesterol management guidelines recommend additional lipid-lowering therapies for secondary prevention in patients with low-density lipoprotein cholesterol ≥70 mg/dL or non-high-density lipoprotein cholesterol ≥100 mg/dL despite maximum tolerated statin therapy. Such patients are considered at very high risk (VHR) based on a history of >1 major atherosclerotic cardiovascular disease (ASCVD) event or a single ASCVD event and multiple high-risk conditions. We investigated the association of US guideline-defined risk categories with the occurrence of ischemic events after acute coronary syndrome and reduction of those events by alirocumab, a PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor. Methods: In the ODYSSEY OUTCOMES trial (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab), patients with recent acute coronary syndrome and residual dyslipidemia despite optimal statin therapy were randomly assigned to alirocumab or placebo. The primary trial outcome (major adverse cardiovascular events, ie, coronary heart disease death, nonfatal myocardial infarction, ischemic stroke, or hospitalization for unstable angina) was examined according to American College of Cardiology/American Heart Association risk category. Results: Of 18 924 participants followed for a median of 2.8 years, 11 935 (63.1%) were classified as VHR: 4450 (37.3%) had multiple prior ASCVD events and 7485 (62.7%) had 1 major ASCVD event and multiple high-risk conditions. Major adverse cardiovascular events occurred in 14.4% of placebo-treated patients at VHR versus 5.6% of those not at VHR. In the VHR category, major adverse cardiovascular events occurred in 20.4% with multiple prior ASCVD events versus 10.7% with 1 ASCVD event and multiple high-risk conditions. Alirocumab was associated with consistent relative risk reductions in both risk categories (hazard ratio=0.84 for VHR; hazard ratio=0.86 for not VHR; Pinteraction=0.820) and by stratification within the VHR group (hazard ratio=0.86 for multiple prior ASCVD events; hazard ratio=0.82 for 1 major ASCVD event and multiple high-risk conditions; Pinteraction=0.672). The absolute risk reduction for major adverse cardiovascular events with alirocumab was numerically greater (but not statistically different) in the VHR group versus those not at VHR (2.1% versus 0.8%; Pinteraction=0.095) and among patients at VHR with multiple prior ASCVD events versus a single prior ASCVD event (2.4% versus 1.8%; Pinteraction=0.661). Conclusions: The US guideline criteria identify patients with recent acute coronary syndrome and dyslipidemia who are at VHR for recurrent ischemic events and who may derive a larger absolute benefit from treatment with alirocumab.spa
dc.description.researchareaCiencias Médicas y de la Saludspa
dc.format.extent12 pspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.doi10.1161/CIRCULATIONAHA.119.042551
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/5711
dc.language.isoengspa
dc.publisherCirculationspa
dc.publisher.placeUSAspa
dc.relation.citationendpage1589spa
dc.relation.citationissue19spa
dc.relation.citationstartpage1578spa
dc.relation.citationvolume140spa
dc.relation.citesRoe MT, Li QH, Bhatt DL, Bittner VA, Diaz R, Goodman SG, Harrington RA, Jukema JW, Lopez-Jaramillo P, Lopes RD, Louie MJ, Moriarty PM, Szarek M, Vogel R, White HD, Zeiher AM, Baccara-Dinet MT, Steg PG, Schwartz GG. Risk Categorization Using New American College of Cardiology/American Heart Association Guidelines for Cholesterol Management and Its Relation to Alirocumab Treatment Following Acute Coronary Syndromes. Circulation. 2019 Nov 5;140(19):1578-1589. doi: 10.1161/CIRCULATIONAHA.119.042551. Epub 2019 Sep 2. PMID: 31475572; PMCID: PMC6830944.
dc.relation.indexedScopusspa
dc.relation.ispartofjournalCirculationspa
dc.rightsCopy Rights: The Author(s), 2019spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución 4.0 Internacional (CC BY 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/spa
dc.sourcehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830944/pdf/cir-140-1578.pdfspa
dc.subject.proposalAcute coronary syndromeeng
dc.subject.proposalAlirocumabeng
dc.subject.proposalDyslipidemiaseng
dc.subject.proposalGuidelineeng
dc.titleRisk Categorization Using New American College of Cardiology/American Heart Association Guidelines for Cholesterol Management and Its Relation to Alirocumab Treatment Following Acute Coronary Syndromesspa
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttp://purl.org/redcol/resource_type/ARTspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dcterms.audienceTodas las Audienciasspa
dspace.entity.typePublication
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2spa
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
Archivos
Paquete original
Mostrando 1 - 1 de 1
Imagen en miniatura
Nombre:
Risk Categorization Using New American College of Cardiology - American Heart Association Guidelines.pdf
Tamaño:
278.8 KB
Formato:
Adobe Portable Document Format
Descripción:
Descargar
Paquete de licencias
Mostrando 1 - 1 de 1
No hay miniatura disponible
Nombre:
license.txt
Tamaño:
59 B
Formato:
Item-specific license agreed upon to submission
Descripción:
Descargar
Colecciones
AGBDA. Artículos de Investigación