Abstract:
AIMS:Statins reduce cardiovascular risk in patients with acute coronary syndrome (ACS) and normal-to-moderately impaired renal function. It is not known whether proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors provide similar benefit across a range of renal function. We determined whether effects of the PCSK9 inhibitor alirocumab to reduce cardiovascular events and death after ACS are influenced by renal function. METHODS AND RESULTS:ODYSSEY OUTCOMES compared alirocumab with placebo in patients with recent ACS and dyslipidaemia despite intensive statin treatment. Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 was exclusionary. In 18 918 patients, baseline eGFR was 82.8 ± 17.6 mL/min/1.73 m2, and low-density lipoprotein cholesterol (LDL-C) was 92 ± 31 mg/dL. At 36 months, alirocumab decreased LDL-C by 48.5% vs. placebo but did not affect eGFR (P = 0.65). Overall, alirocumab reduced risk of the primary outcome (coronary heart disease death, non-fatal myocardial infarction, ischaemic stroke, or unstable angina requiring hospitalization) with fewer deaths. There was no interaction between continuous eGFR and treatment on the primary outcome or death (P = 0.14 and 0.59, respectively). Alirocumab reduced primary outcomes in patients with eGFR ≥90 mL/min/1.73 m2 (n = 7470; hazard ratio 0.784, 95% confidence interval 0.670-0.919; P = 0.003) and 60 to <90 (n = 9326; 0.833, 0.731-0.949; P = 0.006), but not in those with eGFR < 60 (n = 2122; 0.974, 0.805-1.178; P = 0.784). Adverse events other than local injection-site reactions were similar in both groups across all categories of eGFR. CONCLUSIONS:In patients with recent ACS, alirocumab was associated with fewer cardiovascular events and deaths across the range of renal function studied, with larger relative risk reductions in those with eGFR > 60 mL/min/1.73 m2.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Tuñón J,Steg PG,Bhatt DL,Bittner VA,Díaz R,Goodman SG,Jukema JW,Kim YU,Li QH,Mueller C,Parkhomenko A,Pordy R,Sritara P,Szarek M,White HD,Zeiher AM,Schwartz GG,ODYSSEY OUTCOMES Investigators.doi
10.1093/eurheartj/ehaa498subject
Has Abstractpub_date
2020-11-07 00:00:00pages
4114-4123issue
42eissn
0195-668Xissn
1522-9645pii
5895197journal_volume
41pub_type
杂志文章abstract::The patient, a 74-year-old man, developed a persistent nonparoxysmal junctional accelerated rhythm at rate of 60-75 beats min-1 because of chronic depressed sinus node function. Intravenous atropine resulted in no change of junctional pacemaker rate but i.v. isoproterenol significantly accelerated it suggesting that a...
journal_title:European heart journal
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doi:10.1093/oxfordjournals.eurheartj.a061656
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journal_title:European heart journal
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doi:10.1053/euhj.1997.0863
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059805
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journal_title:European heart journal
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doi:
更新日期:1994-06-01 00:00:00
abstract::Nisoldipine is a calcium antagonist with potent coronary vasodilating effects in patients with chronic stable angina pectoris. We studied the acute effects of nisoldipine in six patients within 24 h (mean 14 +/- 4 h) after the onset of myocardial infarction. Nisoldipine was administered as a 4.5 micrograms kg-1 intrav...
journal_title:European heart journal
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doi:10.1093/oxfordjournals.eurheartj.a060125
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更新日期:2012-09-01 00:00:00
abstract:AIMS:Takotsubo syndrome (TTS) is characterized by acute left ventricular dysfunction often triggered by emotional or physical stress. Severe activation of the sympathetic nervous system with catecholamine release caused by a dysfunctional limbic system has been proposed as a potential mechanism. We hypothesize that bra...
journal_title:European heart journal
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060150
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journal_title:European heart journal
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更新日期:1998-11-01 00:00:00
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doi:10.1093/eurheartj/ehq258
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pub_type: 杂志文章,随机对照试验
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更新日期:2007-09-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060567
更新日期:1994-05-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2009-02-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
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journal_title:European heart journal
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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