{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:22:56Z","timestamp":1790252576605,"version":"4.1.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"14","license":[{"start":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T00:00:00Z","timestamp":1655337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Sanofi and Regeneron Pharmaceuticals"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>European guidelines set low-density lipoprotein cholesterol (LDL-C) treatment goals &amp;lt;1.4\u2005mmol\/L after acute coronary syndrome (ACS), and &amp;lt;1.0\u2005mmol\/L for patients with recurrent cardiovascular events \u22642 years. Many ACS patients do not achieve these goals on statin alone. We examined actual goal achievement with alirocumab and projected achievement with ezetimibe, either added to optimized statin therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The ODYSSEY OUTCOMES trial (NCT01663402) compared alirocumab with placebo in 18 924 patients with recent ACS and hyperlipidaemia despite high-intensity or maximum-tolerated statin therapy. This subanalysis comprised 17 589 patients with LDL-C \u22651.4\u2005mmol\/L at baseline who did not receive ezetimibe treatment. High-intensity statin treatment was used in 88.8%. Median (interquartile range) baseline LDL-C was 2.3 (1.9\u22122.7) mmol\/L. With alirocumab, 94.6% of patients achieved LDL-C &amp;lt;1.4\u2005mmol\/L at \u22651 post-baseline measurement vs. 17.3% with placebo. Among 2236 patients with a previous cardiovascular event within 2 years (before the qualifying ACS), 85.2% vs. 3.5%, respectively, achieved LDL-C &amp;lt;1.0\u2005mmol\/L. Among patients not treated with ezetimibe, we projected that its use would have achieved LDL-C &amp;lt;1.4 and &amp;lt;1.0\u2005mmol\/L in 10.6 and 0%, respectively, at baseline (assuming 18 \u00b1 3% reduction of LDL-C).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among patients with recent ACS and LDL-C \u22651.4\u2005mmol\/L despite optimized statin therapy, the addition of alirocumab allowed 94.6% to achieve the 2019 European guideline LDL-C goal &amp;lt;1.4\u2005mmol\/L, and 85.2% of those with recurrent cardiovascular events to achieve &amp;lt;1.0\u2005mmol\/L. In contrast, the addition of ezetimibe to optimized statin therapy was projected to achieve LDL-C &amp;lt;1.4\u2005mmol\/L in only 10.6% of patients at baseline.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwac107","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T11:34:46Z","timestamp":1655379286000},"page":"1842-1851","source":"Crossref","is-referenced-by-count":15,"title":["Achievement of ESC\/EAS LDL-C treatment goals after an acute coronary syndrome with statin and alirocumab"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0214-3203","authenticated-orcid":false,"given":"Ulf","family":"Landmesser","sequence":"first","affiliation":[{"name":"Department of Cardiology, Charite Universit\u00e4tsmedizin Berlin , Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"McGinniss","sequence":"additional","affiliation":[{"name":"Regeneron Pharmaceuticals , Tarrytown, NJ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ph Gabriel","family":"Steg","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Bichat, FACT (French Alliance for Cardiovascular Trials) , INSERM U1148, Paris , France"},{"name":"National Heart and Lung Institute, Imperial College, Royal Brompton Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-6245","authenticated-orcid":false,"given":"Deepak L","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brigham and Women\u2019s Hospital Heart and Vascular Center, Harvard Medical School , 75 Francis Street, Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera A","family":"Bittner","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham , Birmingham, AL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2181-9579","authenticated-orcid":false,"given":"Rafael","family":"Diaz","sequence":"additional","affiliation":[{"name":"Estudios Cl\u00ednicos Latino Am\u00e9rica, Instituto Cardiovascular de Rosario , Rosario , Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirza","family":"Dilic","sequence":"additional","affiliation":[{"name":"University Clinical Center Sarajevo , Sarajevo , Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8068-2440","authenticated-orcid":false,"given":"Shaun G","family":"Goodman","sequence":"additional","affiliation":[{"name":"Canadian VIGOUR Centre, University of Alberta , Edmonton, Alberta , Canada"},{"name":"St. Michael\u2019s Hospital, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Wouter","family":"Jukema","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center , Leiden , The Netherlands"},{"name":"Netherlands Heart Institute , Utrecht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Loy","sequence":"additional","affiliation":[{"name":"Sanofi , New Jersey , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Pe\u0107in","sequence":"additional","affiliation":[{"name":"University of Zagreb, Zagreb School of Medicine, University Hospital Center Zagreb , Zagreb , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8001-6795","authenticated-orcid":false,"given":"Robert","family":"Pordy","sequence":"additional","affiliation":[{"name":"Regeneron Pharmaceuticals , Tarrytown, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steen H","family":"Poulsen","sequence":"additional","affiliation":[{"name":"Aarhus Universitetshospital Skejby , Aarhus N , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0046-0264","authenticated-orcid":false,"given":"Michael","family":"Szarek","sequence":"additional","affiliation":[{"name":"State University of New York, Downstate School of Public Health , Brooklyn, NY , USA"},{"name":"CPC Clinical Research and Division of Cardiology, University of Colorado School of Medicine , Aurora, CO , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvey D","family":"White","sequence":"additional","affiliation":[{"name":"Green Lane Cardiovascular Services Auckland City Hospital , Auckland , New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory G","family":"Schwartz","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine , Aurora, CO , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the ODYSSEY OUTCOMES Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"2022102020075463200_zwac107-B1","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1093\/eurheartj\/ehx144","article-title":"Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel","volume":"38","author":"Ference","year":"2017","journal-title":"Eur Heart J"},{"key":"2022102020075463200_zwac107-B2","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1093\/eurheartj\/ehz962","article-title":"Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel","volume":"41","author":"Boren","year":"2020","journal-title":"Eur Heart J"},{"key":"2022102020075463200_zwac107-B3","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1016\/S0140-6736(10)61350-5","article-title":"Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials","volume":"376","author":"Baigent","year":"2010","journal-title":"Lancet"},{"key":"2022102020075463200_zwac107-B4","doi-asserted-by":"crossref","first-page":"2999","DOI":"10.1093\/eurheartj\/ehw272","article-title":"2016 ESC\/EAS Guidelines for the management of dyslipidaemias","volume":"37","author":"Catapano","year":"2016","journal-title":"Eur Heart J"},{"key":"2022102020075463200_zwac107-B5","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1001\/jama.285.13.1711","article-title":"Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial","volume":"285","author":"Schwartz","year":"2001","journal-title":"JAMA"},{"key":"2022102020075463200_zwac107-B6","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1001\/jama.292.11.1307","article-title":"Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial","volume":"292","author":"de Lemos","year":"2004","journal-title":"JAMA"},{"key":"2022102020075463200_zwac107-B7","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.1056\/NEJMoa1410489","article-title":"Ezetimibe added to statin therapy after acute coronary syndromes","volume":"372","author":"Cannon","year":"2015","journal-title":"N Engl J Med"},{"key":"2022102020075463200_zwac107-B8","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1056\/NEJMoa1615664","article-title":"Evolocumab and clinical outcomes in patients with cardiovascular disease","volume":"376","author":"Sabatine","year":"2017","journal-title":"N Engl J Med"},{"key":"2022102020075463200_zwac107-B9","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1056\/NEJMoa1801174","article-title":"Alirocumab and cardiovascular outcomes after acute coronary syndrome","volume":"379","author":"Schwartz","year":"2018","journal-title":"N Engl J Med"},{"key":"2022102020075463200_zwac107-B10","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2019 ESC\/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk","volume":"41","author":"Mach","year":"2020","journal-title":"Eur Heart J"},{"key":"2022102020075463200_zwac107-B11","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/eurjpc\/zwab154","article-title":"2021 ESC Guidelines on cardiovascular disease prevention in clinical practice","volume":"29","author":"Visseren","year":"2022","journal-title":"Eur J Prev Cardiol"},{"key":"2022102020075463200_zwac107-B12","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.ahj.2014.07.028","article-title":"Effect of alirocumab, a monoclonal antibody to PCSK9, on long-term cardiovascular outcomes following acute coronary syndromes: rationale and design of the ODYSSEY outcomes trial","volume":"168","author":"Schwartz","year":"2014","journal-title":"Am Heart J"},{"key":"2022102020075463200_zwac107-B13","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1056\/NEJMoa1801174","article-title":"Alirocumab and cardiovascular outcomes after acute coronary syndrome","volume":"379","author":"Schwartz","year":"2018","journal-title":"N Engl J Med"},{"key":"2022102020075463200_zwac107-B14","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1007\/s40119-020-00181-8","article-title":"A comparison of ezetimibe and evolocumab for atherogenic lipid reduction in four patient populations: a pooled efficacy and safety analysis of three phase 3 studies","volume":"9","author":"Koren","year":"2020","journal-title":"Cardiol Ther"},{"key":"2022102020075463200_zwac107-B15","doi-asserted-by":"crossref","first-page":"98","DOI":"10.14740\/cr1224","article-title":"Effect of ezetimibe added to high-intensity statin therapy on low-density lipoprotein cholesterol levels: a meta-analysis","volume":"12","author":"Lee","year":"2021","journal-title":"Cardiol Res"},{"key":"2022102020075463200_zwac107-B16","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1136\/bmj.326.7404.1423","article-title":"Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis","volume":"326","author":"Law","year":"2003","journal-title":"BMJ"},{"key":"2022102020075463200_zwac107-B17","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.1177\/2047487319874898","article-title":"Percentage low-density lipoprotein-cholesterol response to a given statin dose is not fixed across the pre-treatment range: real world evidence from clinical practice: data from the ESC-EORP EUROASPIRE V Study","volume":"27","author":"Bacquer","year":"2020","journal-title":"Eur J Prev Cardiol"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwac107\/46053126\/zwac107.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwac107\/46582814\/zwac107.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwac107\/46582814\/zwac107.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T16:09:02Z","timestamp":1666282142000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/29\/14\/1842\/6609258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,16]]},"references-count":17,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2022,6,16]]},"published-print":{"date-parts":[[2022,10,20]]}},"URL":"https:\/\/doi.org\/10.1093\/eurjpc\/zwac107","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,10,1]]},"published":{"date-parts":[[2022,6,16]]}}}