Prevention & lipidsSecondary analysis
Relating Lipoprotein(a) Concentrations to Cardiovascular Event Risk After Acute Coronary Syndrome: A Comparison of 3 Tests
- Secondary analysis of the ODYSSEY OUTCOMES randomised trial
Authors' conclusion
In patients with recent acute coronary syndrome, 3 lipoprotein(a) tests were similarly prognostic for MACE in the placebo group and predictive of MACE reductions with alirocumab at the cohort level.
Study context
- Population
- Patients with recent ACS in the ODYSSEY OUTCOMES trial (alirocumab vs placebo)results from all 3 tests
- Participants
- 11,970 patients
- Comparison
- Lipoprotein tests: IA-mass vs IA-molar vs MS
- Primary endpoint
- MACE: risk in placebo group and risk reduction with alirocumab by baseline lipoprotein(a) per test
Primary result
As reported in the abstract
MACE by baseline lipoprotein(a), per test
Placebo-group major adverse cardiovascular events (MACE) relationships nearly identical across tests; estimated cumulative incidences differing across percentiles
≤0.4%
All tests incrementally prognostic after accounting for LDL-C (spline P)
P≤0.0003
Predicted alirocumab treatment HRs differing between tests across percentiles
≤0.07
Further findings
| Outcome | IA-mass | IA-molar | MS | r |
|---|---|---|---|---|
| Baseline lipoprotein(a) concentration | median 21.8 (IQR 6.9–60.0) mg/dL | median 45.0 (IQR 13.2–153.8) nmol/L | median 42.2 (IQR 14.3–143.1) nmol/L | |
| Correlation between tests — IA-molar vs MS · strongest | 0.990 | |||
| Correlation between tests — IA-mass vs MS | 0.967 | |||
| Correlation between tests — IA-mass vs IA-molar | 0.972 |
Original publication
Relating Lipoprotein(a) Concentrations to Cardiovascular Event Risk After Acute Coronary Syndrome: A Comparison of 3 Tests. Circulation. Published 26 August 2023. doi:10.1161/circulationaha.123.066398
Summarised from the published abstract; every number is checked against it