Cardiology Letters 2018, 27(2):76-86

ODYSSEY OUTCOMES. clinical study: Implications for us

Murín J, Čaprnda M, Kasperová V

I. interná klinika LFUK a UN Bratislava, Nemocnica Staré Mesto, Bratislava, Slovenská republika

Patients suffering acute coronary syndrome (ACS), even with optimal treatment of ACS and optimal secondary prevention treatment afterwards, still have a very high cardiovascular (CV) risk of morbidity and mortality. More intensive treatment of dyslipidemia, with further reduction of serum LDL-Ch levels, to improve the prognosis of these patients - was the hypothesis of this study, with alirocumab (PCSK9 inhibitor) treatment versus placebo treatment. There were 18 924 patients in this study, randomized for the mentioned treatment in the time period of 1 - 12 months after ACS. In the active arm treatment there was a further reduction of serum LDL-Ch level (from 2.62 to 1.37 mmol/l, reduction of 54.7%). This serum LDL-Ch reduction contributed to a reduction of primary end-point (coronary mortality/nonfatal myocardial infarction and stroke/hospitalization for unstable angina pectoris) of 15% (significantly, S), but also components of this endpoint were successfully reduced, and all-cause mortality too by 15% (S). The best benefit was in the subgroup of patients with the highest serum level of LDL-Ch, ≥ 2.6 mmol/l: the primary end-point was reduced by 29% (S) and CV mortality by 31% (S). The treatment was safe. The message of this study is the great reduction of CV events (mortality, nonfatal myocardial infarctions and strokes, unstable angina pectoris) in patients with an ACS treated by alirocumab; and all patients had an excellent standard treatment of this disease, with strong and high doses of statins included. Patients with the highest basal serum LDL-Ch levels (≥ 2.6 mmol/l) profited the most.

Keywords: acute coronary syndrome; hypercholesterolemia alirocumab; cardiovascular events

Published: February 1, 2018  Show citation