Triglyceride Levels, Alirocumab Treatment, and Cardiovascular Outcomes After an Acute Coronary Syndrome
Authors' conclusion
Among patients with recent ACS on optimized statin therapy, baseline triglycerides was associated with cardiovascular risk. However, the reduction in triglycerides with alirocumab did not contribute to its clinical benefit.
Study context
- Population
- Patients with recent acute coronary syndrome (ACS) and elevated atherogenic lipoproteins despite optimized statin therapy
- Participants
- 18,924 patients
- Comparison
- Alirocumab vs placebo, in relation to triglyceride levels
- Primary endpoint
- MACE in relation to continuous or dichotomous triglyceride concentrations
Methodological detailsprespecified and post hoc analyses, placebo-controlled
- Prespecified and post hoc analyses
- Placebo-controlled
Primary result
As reported in the abstract
MACE by triglyceride levels
Estimate (95% CI)P value
Baseline TG +10 mg/dLboth treatment groups
adjusted HR 1.008(1.003–1.013)
P < 0.005Baseline TG ≥150 mg/dLvs <150 mg/dL
HR 1.184(1.080–1.297)
P < 0.00510-mg/dL TG decline, Placebosubsequent MACE
HR 0.988(0.982–0.995)
P < 0.00510-mg/dL TG decline, Alirocumabsubsequent MACE
HR 0.999(0.987–1.010)
P = 0.82- Median baseline triglyceride concentration
- 129 mg/dL
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| MACE | 0.85 (0.78–0.93) | |
| 0.512Hazard ratio (log scale) |
| Outcome | Alirocumab | Placebo |
|---|---|---|
| Triglyceride reduction from baseline · month 4Median, mg/dL | 17.7 | 0.9 |
| P | P < 0.001 | P = NS |
- Major adverse cardiovascular events (MACE) — LDL-C reduction from baseline with alirocumab vs placebo (average)
- 54.7%
Original publication
Triglyceride Levels, Alirocumab Treatment, and Cardiovascular Outcomes After an Acute Coronary Syndrome. J Am Coll Cardiol. Published 10 September 2024. doi:10.
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