The following article is a part of conference coverage from the American College of Cardiology’s 70th Annual Scientific Session & Expo is being held virtually from May 15 to 17, 2021. The team at Cardiology Advisor will be reporting on the latest news and research conducted by clinicians and scientists in the field. Check back for more from the ACC 2021 .

Alirocumab treatment was more efficacious among patients with recent acute coronary syndrome (ACS) diagnosis and a history of myocardial infarction (MI). These findings were presented during the American College of Cardiology annual meeting, held virtually May 15 to 17, 2021, and published in a supplemental issue of the Journal for the American College of Cardiology.


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In this substudy, researchers from National Yang-Ming University in Taiwan and Université de Paris in France analyzed data from the ODYSSEY Outcomes Trial (Clinicaltrials.gov Identifier: NCT01663402), a randomized trial of alirocumab among patients who were recently diagnosed with ACS. They assessed efficacy of alirocumab on reducing major adverse cardiovascular events (MACE) and all-cause mortality on the basis of MI history.

Patients with (n=3633) and without (n=15,291) a history of MI differed significantly for baseline characteristics. A history of MI was more common among men who were older, had more cardiovascular risk factors, and had previous cardiovascular events.

Among the placebo group, patients with a history of MI were associated with increased risk for MACE (adjusted hazard ratio [aHR], 1.85; 95% CI, 1.62-2.11; P <.001) and all-cause mortality (aHR, 1.56; 95% CI, 1.25-1.95; P <.001).

Alirocumab treatment had a relative effect on MACE among patients with (aHR, 0.9; 95% CI, 0.78-1.05) and without (aHR, 0.82; 95% CI, 0.73-0.92) a history of MI (Pint =.34). Alirocumab treatment also had a relative effect on all-cause mortality among patients with (aHR, 0.84; 95% CI, 0.64-1.08) and without (aHR, 0.87; 95% CI, 0.72-1.05) a history of MI (Pint =.81).

The absolute risk reductions with alirocumab were 1.91% for MACE and 1.35% for all-cause mortality among patients with MI history, compared with 1.42% and 0.41% among patients with no prior MI, respectively.

This study may have been biased, as it was a subanalysis of previously collected data.

These data indicated alirocumab therapy effectively reduced risk for MACE and all-cause mortality among patients recently diagnosed with ACS. The protective effect of alirocumab was magnified among patients with a history of MI.

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Reference

Chiang C-E, Schwartz G, Elbez Y, et al. Effects of alirocumab on cardiovascular outcomes in patients with previous myocardial infarction: Subanalysis from the ODYSSEY Outcomes Trial. Presented at: American College of Cardiology (ACC) 2021 Annual Meeting; May 15-17, 2021. Abstract 1016-05.