{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:41:11Z","timestamp":1792788071614,"version":"4.5.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2025,12,16]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Oxidized phospholipids on apolipoprotein B-100 (OxPL-apoB) reflect pro-inflammatory properties of Lp(a) (lipoprotein(a)). The effect of OxPL-apoB on major adverse cardiovascular events (MACE) in patients with acute coronary syndrome in recent the era is not known.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      OxPL-apoB levels and Lp(a) were measured in 11 630 participants before and 5185 participants 4 months after randomization to alirocumab or placebo in the ODYSSEY OUTCOMES trial. Proportional hazards models adjusted for baseline covariates evaluated associations between log\n                      <jats:sub>2<\/jats:sub>\n                      -transformed OxPL-apoB and Lp(a) with MACEs. Interactions between the 2 biomarkers and treatment were also evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Participants were followed for a median 2.9 years; the median age was 58 years, and 23.9% were female. Alirocumab reduced median placebo-adjusted OxPL-apoB by 13.0% and Lp(a) by 26.2% (both\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.0001). In the placebo group, a doubling of baseline OxPL-apoB was associated with a hazard ratio (HR) of 1.081 (95% CI, 1.026\u20131.139;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.0034) for MACEs. Addition of Lp(a) to the model relegated the relationship of OxPL-apoB insignificant. In the alirocumab group, neither OxPL-apoB nor Lp(a) remained significantly associated with MACEs. A significant 3-way interaction was present among continuous log\n                      <jats:sub>2<\/jats:sub>\n                      OxPL-apoB, Lp(a) stratified at the median, and treatment group on MACEs (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      =0.0023) so that, in the placebo group, increasing OxPL-apoB was associated with higher risk of MACEs when Lp(a) was below the median concentration but not above. In the alirocumab group, OxPL-apoB was not related to MACE risk irrespective of Lp(a) concentration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In patients with recent acute coronary syndrome receiving optimized statin treatment, elevated OxPL-apoB levels predicted MACEs, a relationship abrogated by alirocumab. The interaction of OxPL-apoB and Lp(a) in the placebo group indicates that OxPL-apoB independently predicts MACEs when Lp(a) levels are relatively low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifiers: NCT001747 and NCT01663402.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.125.073855","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T10:00:17Z","timestamp":1764583217000},"page":"1666-1678","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Oxidized Phospholipids, Lipoprotein(a), and Cardiovascular Outcomes After Acute Coronary Syndrome"],"prefix":"10.1161","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9834-9494","authenticated-orcid":true,"given":"Sotirios","family":"Tsimikas","sequence":"first","affiliation":[{"name":"Sulpizio Cardiovascular Center, Divisions of Cardiovascular Medicine (S.T.), University of California San Diego, La Jolla, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0046-0264","authenticated-orcid":true,"given":"Michael","family":"Szarek","sequence":"additional","affiliation":[{"name":"CPC Clinical Research, Aurora, CO (M.S.)."},{"name":"State University of New York, Downstate Health Sciences University, Brooklyn, NY (M.S.)."},{"name":"Division of Cardiology, University of Colorado School of Medicine, Aurora, CO (M.S., G.G.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3565-1404","authenticated-orcid":true,"given":"Christa M.","family":"Cobbaert","sequence":"additional","affiliation":[{"name":"Departments of Clinical Chemistry and Laboratory Medicine (C.C., F. R.), Leiden University Medical Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4470-7959","authenticated-orcid":true,"given":"Fred","family":"Romijn","sequence":"additional","affiliation":[{"name":"Departments of Clinical Chemistry and Laboratory Medicine (C.C., F. R.), Leiden University Medical Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3246-8359","authenticated-orcid":true,"given":"J. Wouter","family":"Jukema","sequence":"additional","affiliation":[{"name":"Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands."},{"name":"Netherlands Heart Institute, Utrecht, the Netherlands (J.W.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-6245","authenticated-orcid":true,"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY (D.L.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9456-850X","authenticated-orcid":true,"given":"Vera A.","family":"Bittner","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL (V.A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2181-9579","authenticated-orcid":true,"given":"Rafael","family":"Diaz","sequence":"additional","affiliation":[{"name":"Estudios Cardiologicos Latino America, Instituto Cardiovascular de Rosario, Argentina (R.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8145-8034","authenticated-orcid":true,"given":"Sergio","family":"Fazio","sequence":"additional","affiliation":[{"name":"Regeneron Pharmaceuticals Inc, Tarrytown, NY (S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0486-6325","authenticated-orcid":true,"given":"Genevieve","family":"Garon","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Colorado School of Medicine, Aurora, CO (M.S., G.G.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong","family":"Yuan","sequence":"additional","affiliation":[{"name":"Sanofi, ON, Canada (G.G.). Diazyme Laboratories, Poway, CA (C.Y., X.-M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Min","family":"Gong","sequence":"additional","affiliation":[{"name":"Sanofi, ON, Canada (G.G.). Diazyme Laboratories, Poway, CA (C.Y., X.-M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8068-2440","authenticated-orcid":true,"given":"Shaun G.","family":"Goodman","sequence":"additional","affiliation":[{"name":"St Michael\u2019s Hospital, Unity Health Toronto, and Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada (S.G.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7712-6750","authenticated-orcid":true,"given":"Harvey D.","family":"White","sequence":"additional","affiliation":[{"name":"Health New Zealand Te Whatu Ora, Te Toka Tumai Auckland, Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand (H.D.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5195-6614","authenticated-orcid":true,"given":"Joseph L.","family":"Witztum","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism (J.L.W.), University of California San Diego, La Jolla, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6896-2941","authenticated-orcid":true,"given":"P. 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