Coronary disease & ACSSecondary analysis
Oxidized Phospholipids, Lipoprotein(a), and Cardiovascular Outcomes After Acute Coronary Syndrome
- Secondary analysis of the ODYSSEY OUTCOMES randomised trial
- Median follow-up 2.9 years
Authors' conclusion
In patients with recent acute coronary syndrome receiving optimized statin treatment, elevated OxPL-apoB levels predicted MACEs, a relationship abrogated by alirocumab.
Study context
- Population
- Patients with recent ACS receiving optimized statin treatment5,185 measured at 4 months
- Participants
- 11,630 patients
- Comparison
- Association of OxPL-apoB and Lp with major adverse cardiovascular events (MACE), alirocumab vs placebo
- Primary endpoint
- MACE by log2-transformed OxPL-apoB and Lp(a)
Primary result
MACE per doubling of baseline OxPL-apoB
Hazard ratio
1.081
95% CI 1.026–1.139
P = 0.0034
Doubling of baseline OxPL-apoB
HR 1.081 (95% CI 1.026–1.139); P = 0.0034
Per doubling of baseline OxPL-apoB, as printed
As reported in the abstract
Further findings
Placebo-adjusted change with alirocumab
- Median OxPL-apoB reduction
- 13.0%
- Lp(a) reduction
- 26.2%
- both P<0.0001
3-way interaction: OxPL-apoB × Lp(a) (median) × treatment on MACE
- Placebo: higher OxPL-apoB associated with higher MACE risk when Lp(a) below median, not above; alirocumab: no relation irrespective of Lp(a)
- Pinteraction=0.0023
Original publication
Oxidized Phospholipids, Lipoprotein(a), and Cardiovascular Outcomes After Acute Coronary Syndrome. Circulation. Published 1 December 2025. doi:10.1161/circulationaha.125.073855
Summarised from the published abstract; every number is checked against it