e-Article
Apolipoprotein B, Residual Cardiovascular Risk After Acute Coronary Syndrome, and Effects of Alirocumab
Document Type
Academic Journal
Author
Hagström, Emil; Steg, P. Gabriel; Szarek, Michael; Bhatt, Deepak L.; Bittner, Vera A.; Danchin, Nicolas; Diaz, Rafael; Goodman, Shaun G.; Harrington, Robert A.; Jukema, J. Wouter; Liberopoulos, Evangelos; Marx, Nikolaus; McGinniss, Jennifer; Manvelian, Garen; Pordy, Robert; Scemama, Michel; White, Harvey D.; Zeiher, Andreas M.; Schwartz, Gregory G.; Schwartz, Gregory G.; Bhatt, Deepak L.; Bittner, Vera A.; Diaz, Rafael; Goodman, Shaun G.; Harrington, Robert A.; Jukema, J. Wouter; Szarek, Michael; White, Harvey D.; Zeiher, Andreas M.; Tricoci, Pierluigi; Roe, Matthew T.; Mahaffey, Kenneth W.; Edelberg, Jay M.; Hanotin, Corinne; Lecorps, Guillaume; Moryusef, Angèle; Pordy, Robert; Sasiela, William J.; Tamby, Jean-François; Diaz, Rafael; Aylward, Philip E; Drexel, Heinz; Sinnaeve, Peter; Dilic, Mirza; Lopes, Renato D.; Gotcheva, Nina N; Goodman, Shaun G.; Prieto, Juan-Carlos; Yong, Huo; López-Jaramillo, Patricio; Pećin, Ivan; Reiner, Zeljko; Ostadal, Petr; Poulsen, Steen Hvitfeldt; Viigimaa, Margus; Nieminen, Markku S; Danchin, Nicolas; Chumburidze, Vakhtang; Marx, Nikolaus; Liberopoulos, Evangelos; Carlos, Pablo; Valdovinos, Montenegro; Tse, Hung-Fat; Kiss, Robert Gabor; Xavier, Denis; Zahger, Doron; Valgimigli, Marco; Kimura, Takeshi; Kim, Hyo Soo; Kim, Sang-Hyun; Erglis, Andrejs; Laucevicius, Aleksandras; Kedev, Sasko; Yusoff, Khalid; Ramos López, Gabriel Arturo; Alings, Marco; White, Harvey D.; Halvorsen, Sigrun; Correa Flores, Roger M; Sy, Rody G.; Budaj, Andrzej; Morais, Joao; Dorobantu, Maria; Karpov, Yuri; Ristic, Arsen D.; Chua, Terrance; Murin, Jan; Fras, Zlatko; Dalby, Anthony J; Tuñón, José; de Silva, H. Asita; Hagström, Emil; Landmesser, Ulf; Müller, Christian; Chiang, Chern-En; Sritara, Piyamitr; Guneri, Sema; Parkhomenko, Alexander; Ray, Kausik K.; Moriarty, Patrick M.; Roe, Matthew T.; Vogel, Robert; Chaitman, Bernard; Kelsey, Sheryl F.; Olsson, Anders G.; Rouleau, Jean-Lucien; Simoons, Maarten L.; Alexander, Karen; Meloni, Chiara; Rosenson, Robert; Sijbrands, Eric J.G.; Tricoci, Pierluigi; Alexander, John H.; Armaganijan, Luciana; Bagai, Akshay; Bahit, Maria Cecilia; Brennan, J. Matthew; Clifton, Shaun; DeVore, Adam D.; Deloatch, Shalonda; Dickey, Sheila; Dombrowski, Keith; Ducrocq, Grégory; Eapen, Zubin; Endsley, Patricia; Eppinger, Arleen; Harrison, Robert W.; Hess, Connie Ng; Hlatky, Mark A.; Jordan, Joseph Dedrick; Knowles, Joshua W.; Kolls, Bradley J.; Kong, David F.; Leonardi, Sergio; Lillis, Linda; Lopes, Renato D.; Maron, David J.; Mahaffey, Kenneth W.; Marcus, Jill; Mathews, Robin; Mehta, Rajendra H.; Mentz, Robert J.; Moreira, Humberto Graner; Patel, Chetan B.; Pereira, Sabrina Bernardez; Perkins, Lynn; Povsic, Thomas J.; Puymirat, Etienne; Roe, Matthew T.; Jones, William Schuyler; Shah, Bimal R.; Sherwood, Matthew W.; Stringfellow, Kenya; Sujjavanich, Darin; Toma, Mustafa; Trotter, Charlene; van Diepen, Sean F.P.; Wilson, Matthew D.; Tze-Kay Yan, Andrew; Schiavi, Lilia B; Garrido, Marcelo; Alvarisqueta, Andrés F; Sassone, Sonia A; Bordonava, Anselmo P; Alves De Lima, Alberto E; Schmidberg, Jorge M; Duronto, Ernesto A; Caruso, Orlando C; Novaretto, Leonardo P; Hominal, Miguel Angel; Montaña, Oscar R; Caccavo, Alberto; Gomez Vilamajo, Oscar A; Lorenzatti, Alberto J; Cartasegna, Luis R; Paterlini, Gustavo A; Mackinnon, Ignacio J; Caime, Guillermo D; Amuchastegui, Marcos; Salomone, Oscar; Codutti, Oscar R; Jure, Horacio O; Bono, Julio OE; Hrabar, Adrian D; Vallejos, Julio A; Ahuad Guerrero, Rodolfo A; Novoa, Federico; Patocchi, Cristian A; Zaidman, Cesar J; Giuliano, Maria E; Dran, Ricardo D; Vico, Marisa L; Carnero, Gabriela S; Guzman, Pablo N; Medrano Allende, Juan C; Garcia Brasca, Daniela F; Bustamante Labarta, Miguel H; Nani, Sebastian; Blumberg, Eduardo DS; Colombo, Hugo R; Liberman, Alberto; Fuentealba, Victorino; Luciardi, Hector L; Waisman, Gabriel D; Berli, Mario A; Garcia Duran, Ruben O; Cestari, Horacio G; Luquez, Hugo A; Giordano, Jorge A; Saavedra, Silvia S; Zapata, Gerardo; Costamagna, Osvaldo; Llois, Susana; Waites, Jonathon H; Collins, Nicholas; Soward, Allan; Aylward, Philip E; Hii, Chris LS; Aylward, Philip E; Shaw, James; Arstall, Margaret A; Horowitz, John; Ninio, Daniel; Rogers, James F; Colquhoun, David; Oqueli Flores, Romulo E; Roberts-Thomson, Philip; Raffel, Owen; Lehman, Sam J; Aroney, Constantine; Coverdale, Steven GM; Garrahy, Paul J; Starmer, Gregory; Sader, Mark; Carroll, Patrick A; Dick, Ronald; Zweiker, Robert; Hoppe, Uta; Drexel, Heinz; Huber, Kurt; Berger, Rudolf; Delle-Karth, Georg; Frey, Bernhard; Weidinger, Franz; Faes, Dirk; Hermans, Kurt; Pirenne, Bruno; Leone, Attilio; Hoffer, Etienne; Sinnaeve, Peter; Vrolix, Mathias CM; Wolf, Luc De; Wollaert, Bart; Castadot, Marc; Dujardin, Karl; Beauloye, Christophe; Vervoort, Geert; Striekwold, Harry; Convens, Carl; Roosen, John; Barbato, Emanuele; Claeys, Marc; Cools, Frank; Terzic, Ibrahim; Barakovic, Fahir; Midzic, Zlatko; Pojskic, Belma; Fazlibegovic, Emir; Dilic, Mirza; Durak-Nalbantic, Azra; Kulić, Mehmed; Vulic, Dusko; Muslibegovic, Adis; Goronja, Boris; Reis, Gilmar; Sousa, Luciano; Nicolau, Jose C; Giorgeto, Flavio E; Silva, Ricardo P; Maia, Lilia Nigro; Rech, Rafael; Rossi, Paulo RF; Cerqueira, Maria José AG; Duda, Norberto; Kalil, Renato; Kormann, Adrian; Abrantes, José Antonio M; Filho, Pedro Pimentel; Soggia, Ana Priscila; de Santos, Mayler ON; Neuenschwander, Fernando; Bodanese, Luiz C; Michalaros, Yorghos L; Eliaschewitz, Freddy G; Vidotti, Maria H; Leaes, Paulo E; Botelho, Roberto V; Kaiser, Sergio; Manenti, Euler Roberto F Fernandes; Precoma, Dalton B; Moura Jorge, Jose C; Silva, Pedro; Silveira, Jose A; Saporito, Wladmir; Neto, Jose A Marin; Feitosa, Gilson S; Ritt, Luiz Eduardo F; de Souza, Juliana A; Costa, Fernando; Souza, Weimar KSB; Reis, Helder JL; Lopes, Renato D.; Machado, Leandro; Aidar Ayoub, José Carlos; Todorov, Georgi V; Nikolov, Fedya P; Velcheva, Elena S; Tzekova, Maria L; Benov, Haralambi O; Petranov, Stanislav L; Tumbev, Haralin S; Shehova-Yankova, Nina S; Markov, Dimitar T; Raev, Dimitar H; Mollov, Mihail N; Kichukov, Kostadin N; Ilieva- Pandeva, Katya A; Gotcheva, Nina N; Ivanova, Raya; Gospodinov, Maryana; Mincheva, Valentina M; Lazov, Petar V; Dimov, Bojidar I; Senaratne, Manohara; Stone, James; Kornder, Jan; Pearce, Stephen; Dion, Danielle; Savard, Daniel; Pesant, Yves; Pandey, Amritanshu; Robinson, Simon; Gosselin, Gilbert; Vizel, Saul; Hoag, Gordon; Bourgeois, Ronald; Morisset, Anne; Sabbah, Eric; Sussex, Bruce; Kouz, Simon; MacDonald, Paul; Diaz, Ariel; Michaud, Nicolas; Fell, David; Leung, Raymond; Vuurmans, Tycho; Lai, Christopher; Nigro, Frank; Davies, Richard; Nogareda, Gustavo; Vijayaraghavan, Ram; Ducas, John; Lepage, Serge; Mehta, Shamir; Cha, James; Dupuis, Robert; Fong, Peter; Lutchmedial, Sohrab; Rodes-Cabau, Josep; Fadlallah, Hussein; Cleveland, David; Huynh, Thao; Bata, Iqbal; Hameed, Adnan; Pincetti, Cristian; Potthoff, Sergio; Prieto, Juan C; Acevedo, Monica; Aguirre, Arnoldo; Vejar, Margarita; Yañez, Mario; Araneda, Guillermo; Fernandez, Mauricio; Perez, Luis; Varleta, Paola; Florenzano, Fernando; Huidobro, Laura; Raffo, Carlos A; Olivares, Claudia; Nahuelpan, Leonardo; Montecinos, Humberto; Chen, Jiyan; Dong, Yugang; Huang, Weijian; Wang, Jianzhong; Huang, Shi’An; Yao, Zhuhua; Li, Xiang; Cui, Lan; Lin, Wenhua; Sun, Yuemin; Wang, Jingfeng; Li, Jianping; Zhang, Xuelian; Zhu, Hong; Chen, Dandan; Huang, Lan; Dong, Shaohong; Su, Guohai; Xu, Biao; Su, Xi; Cheng, Xiaoshu; Lin, Jinxiu; Zong, Wenxia; Li, Huanming; Feng, Yi; Xu, Dingli; Yang, Xinchun; Ke, Yuannan; Lin, Xuefeng; Zhang, Zheng; Zheng, Zeqi; Luo, Zhurong; Chen, Yundai; Ding, Chunhua; Zhong, Yi; Zheng, Yang; Li, Xiaodong; Peng, Daoquan; Zhao, Shuiping; Li, Ying; Liu, Xuebo; Wei, Meng; Liu, Shaowen; Yu, Yihua; Qu, Baiming; Jiang, Weihong; Zhou, Yujie; Zhao, Xingsheng; Yuan, Zuyi; Guo, Ying; Xu, Xiping; Shi, Xubo; Ge, Junbo; Fu, Guosheng; Bai, Feng; Fang, Weiyi; Shou, Xiling; Yang, Xiangjun; Wang, Jian’An; Xiang, Meixiang; Sun, Yingxian; Lu, Qinghua; Zhang, Ruiyan; Zhu, Jianhua; Xu, Yizhou; Fan, Zhongcai; Li, Tianchang; Wu, Chun; Jaramillo, Nicolas; Vallejo, Gregorio Sanchez; Luna Botia, Diana C; Lopez, Rodrigo Botero; De Salazar, Dora I Molina; Bonfanti, Alberto J Cadena; Aroca, Carlos Cotes; Higuera, Juan Diego; Blanquicett, Marco; Barrera Silva, Sandra I; Garcia Lozada, Henry J; Coronel Arroyo, Julian A; Accini Mendoza, Jose L; Fernandez Ruiz, Ricardo L; Quintero Ossa, Alvaro M.; Manzur Jatin, Fernando G; Sotomayor Herazo, Aristides; Parada, Jeffrey Castellanos; Arambula, Rafael Suarez; Urina Triana, Miguel A; Trujillo, Angela M Fernandez; Strozzi, Maja; Car, Siniša; Miličić, Davor; Lovrić Benčić, Martina; Pintarić, Hrvoje; Prvulović, Đeiti; Šikić, Jozica; Peršić, Viktor; Mileta, Dean; Štambuk, Kresimir; Babić, Zdravko; Tomulic, Vjekoslav; Lukenda, Josip; Mejic-Krstulovic, Stanka; Starcevic, Boris; Spinar, Jindrich; Horak, David; Velicka, Zdenek; Alan, David; Machova, Vilma; Linhart, Ales; Novotny, Vojtech; Kaucak, Vladimir; Rokyta, Richard; Naplava, Robert; Coufal, Zdenek; Adamkova, Vera; Podpera, Ivo; Zizka, Jiri; Motovska, Zuzana; Marusincova, Ivana; Ostadal, Petr; Heinc, Petr; Kuchar, Jiri; Povolny, Petr; Matuska, Jiri; Poulsen, Steen H; Raungaard, Bent; Clemmensen, Peter; Bang, Lia E; May, Ole; Bøttcher, Morten; Hove, Jens D; Frost, Lars; Gislason, Gunnar; Larsen, John; Johansen, Peter Betton; Hald, Flemming; Johansen, Peter; Jeppesen, Jørgen; Nielsen, Tonny; Kristensen, Kjeld S; Walichiewicz, Piotr Maria; Lomholdt, Jens D; Klausen, Ib C; Nielsen, Peter Kaiser; Davidsen, Flemming; Videbaek, Lars; Viigimaa, Margus; Soots, Mai; Vahula, Veiko; Hedman, Anu; Soopõld, Üllar; Märtsin, Kaja; Jurgenson, Tiina; Kristjan, Arved; Nieminen, Markku S; Vikman, Saila; Huikuri, Heikki; Airaksinen, Juhani; Coste, Pierre; Ferrari, Emile; Danchin, Nicolas; Morel, Olivier; Montalescot, Gilles; Machecourt, Jacques; Barone-Rochette, Gilles; Mansourati, Jacques; Cottin, Yves; Steg, Ph. Gabriel; Leclercq, Florence; Belhassane, Abdelkader; Delarche, Nicolas; Boccara, Franck; Paganelli, Franck; Clerc, Jérôme; Schiele, Francois; Aboyans, Victor; Probst, Vincent; Berland, Jacques; Lefèvre, Thierry; Chumburidze, Vakhtang; Khintibidze, Irakli; Shaburishvili, Tamaz; Pagava, Zurab; Ghlonti, Ramaz; Lominadze, Zaza; Khabeishvili, George; Hemetsberger, Rayyan; Edward, Kemala; Rauch-Kröhnert, Ursula; Stratmann, Matthias; Appel, Karl-Friedrich; Schmidt, Ekkehard; Omran, Heyder; Stellbrink, Christoph; Dorsel, Thomas; Lianopoulos, Emmanouil; Vöhringer, Hans Friedrich; Marx, Roger; Zirlik, Andreas; Schellenberg, Detlev; Heitzer, Thomas; Laufs, Ulrich; Werner, Christian; Marx, Nikolaus; Gielen, Stephan; Nuding, Sebastian; Winkelmann, Bernhard; Behrens, Steffen; Sydow, Karsten; Karakas, Mahir; Simonis, Gregor; Muenzel, Thomas; Werner, Nikos; Leggewie, Stefan; Böcker, Dirk; Braun- Dullaeus, Rüdiger; Toursarkissian, Nicole; Jeserich, Michael; Weißbrodt, Matthias; Schaeufele, Tim; Weil, Joachim; 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Govinda, Ravishankar A; Oomman, Abraham; Sinha, Dhurjati; Patil, Sachin N; Kahali, Dhiman; Sawhney, Jitendra; Joshi, Abhijeet B; Chaudhary, Sanjeev; Harkut, Pankaj; Guha, Santanu; Porwal, Sanjay; Jujjuru, Srimannarayana; Pothineni, Ramesh B; Monteiro, Minguel R; Khan, Aziz; Iyengar, Shamanna S; Grewal, Jasprakash Singh; Chopda, Manoj; Fulwani, Mahesh C; Patange, Dr. Aparna; Sachin, Patil; Chopra, Vijay K; Goyal, Naresh K; Shinde, Rituparna; Manakshe, Gajendra V; Patki, Nitin; Sethi, Sumeet; Munusamy, Vengatesh; Sunil Thanvi, Sunil Karnaand; Adhyapak, Srilakshmi; Patil, Chandrakant; Pandurangi, Ulhas; Mathur, Rishabh; Gupta, Jugal; Kalashetti, Suhas; Bhagwat, Ajit; Raghuraman, Bagirath; Kumar Yerra, Shiv; Bhansali, Prasant; Borse, Rohidas; Rahul, Patil; Das, Srihari; Kumar, Vinay; Abdullakutty, Jabir; Saathe, Shireesh; Palimkar, Priya; Abdullkutty, Jabir; Sathe, Shireesh; Atar, Shaul; Shechter, Michael; Mosseri, Morris; Arbel, Yaron; Ehud, Chorin; Ofer, Havakuk; Lotan, Chaim; Rosenschein, Uri; Katz, Amos; Henkin, Yaakov; Francis, Adi; Klutstein, Marc; Nikolsky, Eugenia; Zukermann, Robert; Turgeman, Yoav; Halabi, Majdi; Marmor, Alon; Kornowski, Ran; Jonas, Michael; Amir, Offer; Hasin, Yonathan; Rozenman, Yoseph; Fuchs, Shmuel; Zvi, Vered; Hussein, Osamah; Gavish, Dov; Vered, Zvi; Caraco, Yoseph; Elias, Mazen; Tov, Naveh; Wolfovitz, Efrat; Lishner, Michael; Elias, Nizar; Piovaccari, Giancarlo; Pellegrin, Annamaria De; Garbelotto, Raffaella; Guardigli, Gabriele; Marco, Valgimigli; Licciardello, Giovanni; Auguadro, Carla; Scalise, Filippo; Cuccia, Claudio; Salvioni, Alessandro; Musumeci, Giuseppe; Senni, Michelle; Calabrò, Paolo; Novo, Salvatore; Faggiano, Pompilio; Metra, Marco; De Cesare, Nicoletta B; Berti, Sergio; Puccioni, Enrico; Galvani, Marcello; Tespili, Maurizio; Piatti, Piermarco; Palvarini, Michela; Luca, Giuseppe De; Violini, Roberto; Leo, Alessandro De; Olivari, Zoran; Filardi, Pasquale Perrone; Ferratini, Maurizio; Racca, Vittorio; Dai, Kazuoki; Shimatani, Yuji; Kamiya, Haruo; Ando, Kenji; Takeda, Yoshihiro; Morino, Yoshihiro; Hata, Yoshiki; Kimura, Kazuo; Kishi, Koichi; Michishita, Ichiro; Uehara, Hiroki; Higashikata, Toshinori; Hirayama, Atsushi; Hirooka, Keiji; Doi, Yasuji; Sakagami, Satoru; Taguchi, Shuichi; Koike, Akihiro; Fujinaga, Hiroyuki; Koba, Shinji; Kozuma, Ken; Kawasaki, Tomohiro; Ono, Yujiro; Shimizu, Masatoshi; Katsuda, Yousuke; Wada, Atsuyuki; Shinke, Toshiro; Kimura, Takeshi; Ako, Junya; Fujii, Kenshi; Takahashi, Toshiyuki; Nakao, Koichi; Furukawa, Yutaka; Sugino, Hiroshi; Tamura, Ritsu; Mano, Toshiaki; Uematsu, Masaaki; Utsu, Noriaki; Ito, Kashima; Haraguchi, Takuya; Sato, Katsuhiko; Ueda, Yasunori; Nishibe, Akira; Fujimoto, Kazuteru; Masutani, Motomaru; Nishibe, Akira; Fujimoto, Kazuteru; Yoon, Jung Han; Kim, Sang-Hyun; Kim, Hack-Lyoung; Sik Park, Hun; Chae, In-Ho; Kim, Moo Hyun; Jeong, Myung Ho; Rha, Seungwoon; Kim, Chongjin; Kim, Hyo-Soo; Kim, Hae Young; Hong, Taekjong; Tahk, Seung-Jea; Kim, Youngkwon; Busmane, Arija; Pontaga, Natalija; Strelnieks, Aldis; Mintale, Iveta; Sime, Iveta; Petrulioniene, Zaneta; Kavaliauskiene, Roma; Jurgaitiene, Ruta; Sakalyte, Gintare; Slapikas, Rimvydas; Norkiene, Sigute; Misonis, Nerijus; Kibarskis, Aleksandras; Kubilius, Raimondas; Bojovski, Stojko; Kedev, Sasko; Lozance, Nensi; Kjovkaroski, Aleksandar; Doncovska, Snezana; Ong, Tiong Kiam; Kasim, Sazzli; Maskon, Oteh; Kandasamy, Balachandran; Yusoff, Khalid; Liew, Houng B; Wan Mohamed, Wan Mohd Izani; Castillo, Armando García; Ramos López, Gabriel Arturo; Calvillo, Jorge Carrillo; Campos, Pedro Fajardo; Núñez Fragoso, Juan Carlos; Bayram Llamas, Edmundo Alfredo; Alcocer Gamba, Marco Antonio; Madrigal, Jaime Carranza; González Salas, Luis Gerardo; Rosas, Enrique López; González Díaz, Belinda; Vázquez, Eduardo Salcido; Nacoud Ackar, Alfredo; Llamas Esperón, Guillermo Antonio; Martínez Sánchez, Carlos Rodolfo; De Leon, María Guerrero; Suarez Otero, Rodrigo; Salmón, Guillermo Fanghänel; Pérez Ríos, Jesús Antonio; Garza Ruíz, José Angel; Alings, Marco; Breedveld, Robert W; Feenema-Aardema, Margriet; Borger-Van Der Burg, Alida; Hoogslag, Pieter AM; Suryapranata, Harry; Oomen, Antonius; Van Haelst, Paulus; Feenema-Aradema, Margriet; Wiersma, Jacobijne J; Basart, Dirk; Van Der Wal, Ruud MA; Zwart, Peter; Monraats, Pascalle; Van Kesteren, Henricus; Karalis, Ioannis; Jukema, Johan; Verdel, Gerardus JE; Brueren, Bart RG; Troquay, Roland PTh; Viergever, Eric P; Al-Windy, Nadea YY; Bartels, Gerard L; Cornel, Jan H; Hermans, Walter RM; Herrman, Johannes PR; Bos, Robert J; Groutars, Reginald GEJ; Van Der Zwaan, Coenraad C; Kaplan, Refik; Ronner, Eelko; Groenemeijer, Bjorn E; Bronzwaer, Patrick NA; Liem, Anho AH; Rensing, Bernard JWM; Bokern, Marcel JJA; Nijmeijer, Remco; Hersbach, Ferry MRJ; Willems, Frank F; Gosselink, Antonius TM; Rasoul, Saman; Elliott, John; Wilkins, Gerard; Fisher, Raewyn; Scott, Douglas; Hart, Hamish; Stewart, Ralph; Harding, Scott; Ternouth, Ian; Fisher, Nicholas; Wilson, Samuel; Aitken, Denise; Anscombe, Russell; Davidson, Laura; Tomala, Tadeusz; Nygård, Ottar; Sparby, Jon Arne; Andersen, Kjell; Gullestad, Lars; Jortveit, Jarle; Munk, Peter S; Singsaas, Erlend gyllensten; Halvorsen, Sigrun; Hurtig, Ulf; Correa Flores, Roger M; Calderon Ticona, Jorge R; Durand Velasquez, Julio R; Negron Miguel, Sandra A; Sanabria Perez, Enrique S; Carrion Chambilla, Jesus M; Chavez Ayala, Carlos A; Castillo Leon, Reynaldo P; Vargas GonzalesC, Rolando J; Hernandez Zuniga, Jose D; Camacho Cosavalente, Luis A; Bravo Mannucci, Jorge E; Landeo, Javier Heredia; Llerena Navarro, Nassip C; Roldan Concha, Yudy M; Rodriguez Chavez, Víctor E; Anchante Hernandez, Henry A; Zea Nunez, Carlos A; Ramos, Walter Mogrovejo; Ferrolino, Arthur; Sy, Rosa Allyn G; Tirador, Louie; Sy, Rody G.; Matiga, Generoso; Coching, Raul Martin; Bernan, Alisa; Rogelio, Gregorio; Morales, Dante D.; Tan, Edgar; Sulit, Dennis Jose; Wlodarczak, Adrian; Skonieczny, Grzegorz; Pawlowicz, Lidia; Wojewoda, Pawel; Busz-Papiez, Benita; Bednarski, Janusz; Goch, Aleksander; Staneta, Pawel; 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Source
Circulation. Aug 30, 2022 146(9):657-672
Subject
Language
English
ISSN
0009-7322
Abstract
BACKGROUND:: Apolipoprotein B (apoB) provides an integrated measure of atherogenic risk. Whether apoB levels and apoB lowering hold incremental predictive information on residual risk after acute coronary syndrome beyond that provided by low-density lipoprotein cholesterol is uncertain. METHODS:: The ODYSSEY OUTCOMES trial (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) compared the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome and elevated atherogenic lipoproteins despite optimized statin therapy. Primary outcome was major adverse cardiovascular events (MACE; coronary heart disease death, nonfatal myocardial infarction, fatal/nonfatal ischemic stroke, hospitalization for unstable angina). Associations between baseline apoB or apoB at 4 months and MACE were assessed in adjusted Cox proportional hazards and propensity score–matched models. RESULTS:: Median follow-up was 2.8 years. In proportional hazards analysis in the placebo group, MACE incidence increased across increasing baseline apoB strata (3.2 [95% CI, 2.9–3.6], 4.0 [95% CI, 3.6–4.5], and 5.5 [95% CI, 5.0–6.1] events per 100 patient-years in strata <75, 75–<90, ≥90 mg/dL, respectively; Ptrend<0.0001) and after adjustment for low-density lipoprotein cholesterol (Ptrend=0.035). Higher baseline apoB stratum was associated with greater relative (Ptrend<0.0001) and absolute reduction in MACE with alirocumab versus placebo. In the alirocumab group, the incidence of MACE after month 4 decreased monotonically across decreasing achieved apoB strata (4.26 [95% CI, 3.78–4.79], 3.09 [95% CI, 2.69–3.54], and 2.41 [95% CI, 2.11–2.76] events per 100 patient-years in strata ≥50, >35–<50, and ≤35 mg/dL, respectively). Compared with propensity score–matched patients from the placebo group, treatment hazard ratios for alirocumab also decreased monotonically across achieved apoB strata. Achieved apoB was predictive of MACE after adjustment for achieved low-density lipoprotein cholesterol or non–high-density lipoprotein cholesterol but not vice versa. CONCLUSIONS:: In patients with recent acute coronary syndrome and elevated atherogenic lipoproteins, MACE increased across baseline apoB strata. Alirocumab reduced MACE across all strata of baseline apoB, with larger absolute reductions in patients with higher baseline levels. Lower achieved apoB was associated with lower risk of MACE, even after accounting for achieved low-density lipoprotein cholesterol or non–high-density lipoprotein cholesterol, indicating that apoB provides incremental information. Achievement of apoB levels as low as ≤35 mg/dL may reduce lipoprotein-attributable residual risk after acute coronary syndrome. REGISTRATION:: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01663402.