Open this publication in new window or tab >>Division of Cardiovascular Disease, University of Alabama at Birmingham, 701 19th Street South - LHRB 310, Birmingham, AL 35294, United States.
Estudios Cardiológicos Latinoamérica, Instituto Cardiovascular de Rosario, Paraguay 160, Rosario, Santa Fe, Argentina.
Sanofi, 55 Corporate Drive, Bridgewater, NJ 08807, United States.
Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, University of Latvia, Pilsonu Street 13, Riga, LV1002, Latvia.
Canadian VIGOUR Centre, 2-132 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, AB T6G 2E1, Canada; St. Michael’s Hospital, University of Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
Sanofi, 54-56 Rue la Boétie, Paris, 75008, France.
Stanford Center for Clinical Research, Department of Medicine, 300 Pasteur Drive, S-102, Stanford, CA 94305, United States.
Department of Cardiology, Leiden University Medical Center, 2300 RC, Leiden, Netherlands.
Duke Clinical Research Institute, 200 Morris Street, Durham, NC 27710, United States.
Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Grant S-102, Stanford, CA 94305, United States.
Sanofi, 55 Corporate Drive, Bridgewater, NJ 08807, United States.
Regeneron Pharmaceuticals, 777 Old Saw Mill River Road, Tarrytown, NY 10591, United States.
Duke Clinical Research Institute, 200 Morris Street, Durham, NC 27710, United States.
Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road10400, Thailand.
CSL Behring, 1100 N Miami Blvd Ste 613, Durham, NC 27703, United States.
Department of Medicine III, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main, 60590, Germany.
Division of Cardiology, University of Colorado School of Medicine, 1700 N. Wheeling Street, Aurora, CO 80045, United States.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
Show others...
2019 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 40, no 33, p. 2801-2809Article in journal (Refereed) Published
Abstract [en]
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. © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.
Place, publisher, year, edition, pages
Oxford University Press, 2019
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-162037 (URN)10.1093/eurheartj/ehz299 (DOI)000490154300015 ()31121022 (PubMedID)2-s2.0-85070265173 (Scopus ID)
2019-11-182019-11-182020-01-09