prikaz prve stranice dokumenta Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES
  Download
PDF 418.63 KB
Scientific paper - Original scientific paper
Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES
Circulation, 140 (2019), 25; 2054-2062. https://doi.org/10.1161/CIRCULATIONAHA.119.043826
Jukema, J. Wouter; Zijlstra, Laurien E.; Bhatt, Deepak L.; Bittner, Vera A.; Diaz, Rafael; Drexel, Heinz; Goodman, Shaun G.; Kim, Yong-Un; Pordy, Robert; Reiner, Željko; Roe, Matthew T.; Tse, Hung-Fat; Montenegro Valdovinos, Pablo Carlos; White, Harvey D.; Zeiher, Andreas M.; Szarek, Michael; Schwartz, Gregory G.; Steg, Philippe Gabriel More authors...

Cite this document

Jukema, J. W., Zijlstra, L. E., Bhatt, D. L., Bittner, V. A., Diaz, R., Drexel, H. ... Steg, P. G. (2019). Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES. Circulation, 140. (25), 2054-2062. doi: 10.1161/CIRCULATIONAHA.119.043826

Jukema, J. Wouter, et al. "Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES." Circulation, vol. 140, no. 25, 2019, pp. 2054-2062. https://doi.org/10.1161/CIRCULATIONAHA.119.043826

Jukema, J. Wouter, Laurien E. Zijlstra, Deepak L. Bhatt, Vera A. Bittner, Rafael Diaz, Heinz Drexel, Shaun G. Goodman, et al. "Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES." Circulation 140, no. 25 (2019): 2054-2062. https://doi.org/10.1161/CIRCULATIONAHA.119.043826

Jukema, J. W., et al. (2019) 'Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES', Circulation, 140(25), pp. 2054-2062. doi: 10.1161/CIRCULATIONAHA.119.043826

Jukema JW, Zijlstra LE, Bhatt DL, Bittner VA, Diaz R, Drexel H, and sur.. Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES. Circulation [Internet]. 2019 December 17 [cited 2025 January 23];140(25):2054-2062. doi: 10.1161/CIRCULATIONAHA.119.043826

J. W. Jukema, et al., "Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES", Circulation, vol. 140, no. 25, pp. 2054-2062, December 2019. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:105:940103. [Accessed: 23 January 2025]

Please login to the repository to save this object to your list.
Metadata
Title (english)Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES
AuthorJ. Wouter Jukema
AuthorLaurien E. Zijlstra
AuthorDeepak L. Bhatt
AuthorVera A. Bittner
AuthorRafael Diaz
AuthorHeinz Drexel
AuthorShaun G. Goodman
AuthorYong-Un Kim
AuthorRobert Pordy
AuthorŽeljko Reiner
AuthorMatthew T. Roe
AuthorHung-Fat Tse
AuthorPablo Carlos Montenegro Valdovinos
AuthorHarvey D. White
AuthorAndreas M. Zeiher
AuthorMichael Szarek
AuthorGregory G. Schwartz
AuthorPhilippe Gabriel Steg
Author's institutionUniversity of Zagreb
School of Medicine
(Department of Internal Medicine)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Abstract (english)
Background: Lowering of atherogenic lipoproteins, including low-density lipoprotein cholesterol (LDL-C), reduces the risk of ischemic stroke. However, concerns have been raised about very low LDL-C levels and a potential increased risk of hemorrhagic stroke. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome and elevated atherogenic lipoproteins, despite intensive statin therapy, targeting LDL-C levels of 25 to 50 mg/dL and avoiding sustained LDL-C <15 mg/dL. This prespecified analysis was designed to assess the effect of alirocumab on ischemic and hemorrhagic stroke. We hypothesized that for patients treated with alirocumab there would be a reduction in risk of ischemic stroke without increasing hemorrhagic stroke, irrespective of baseline LDL-C and of history of cerebrovascular disease. ----- Methods: Patients were randomized to alirocumab or placebo 1 to 12 months after acute coronary syndrome. The risk of nonfatal or fatal ischemic or hemorrhagic stroke was evaluated, stratified by baseline LDL-C concentration and history of cerebrovascular disease. A potential association of very low achieved LDL-C with alirocumab treatment at month 4 and subsequent hemorrhagic stroke was assessed. ----- Results: Median follow-up was 2.8 years. In total, 263 ischemic and 33 hemorrhagic strokes occurred. Alirocumab reduced the risk of any stroke (HR, 0.72 [95% CI, 0.57-0.91]) and ischemic stroke (HR, 0.73 [95% CI, 0.57-0.93]) without increasing hemorrhagic stroke (HR, 0.83 [95% CI, 0.42-1.65]). In total, 7164 (37.9%), 6128 (32.4%), and 5629 (29.7%) patients had a baseline LDL-C of <80, 80 to 100, and >100 mg/dL, respectively. The treatment effect on stroke appeared numerically greater for patients with higher baseline LDL-C, but there was no formal evidence of heterogeneity (Pinteraction=0.31). The effect of alirocumab on stroke was similar among 944 patients (5.0%) with a history of previous cerebrovascular disease and among those without a history of cerebrovascular disease (Pinteraction=0.37). There was no apparent adverse relation between lower achieved LDL-C and incidence of hemorrhagic stroke in the alirocumab group. ----- Conclusions: In patients with recent acute coronary syndrome and dyslipidemia despite intensive statin therapy, alirocumab decreased the risk of stroke, irrespective of baseline LDL-C and history of cerebrovascular disease, over a median follow-up of 2.8 years. Furthermore, risk of hemorrhagic stroke did not depend on achieved LDL-C levels within the alirocumab group.
Keywords (english)
Languagecroatian
Publication typeScientific paper - Original scientific paper
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleCirculation
Numberingvol. 140, no. 25, pp. 2054-2062
p-ISSN0009-7322
e-ISSN1524-4539
DOIhttps://doi.org/10.1161/CIRCULATIONAHA.119.043826
URN:NBNurn:nbn:hr:105:940103
Publication2019-12-17
Document URLhttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.043826
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution 4.0 International (CC BY 4.0) icon
Created on2021-02-16 11:44:25