{"id":"8827fd0c14e5","type":"article","url":"https://hartvaat.nl/2020/11/07/alirocumab-en-mace-naar-nierfunctie-na-acs-odyssey-outcomes/","title":"Alirocumab en MACE naar nierfunctie na ACS: ODYSSEY OUTCOMES","title_en":"Effect of alirocumab on major adverse cardiovascular events according to renal function in patients with a recent acute coronary syndrome: prespecified analysis from the ODYSSEY OUTCOMES randomized clinical trial.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog","internist"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehaa498","source_url":"https://doi.org/10.1093/eurheartj/ehaa498","authors":["José Tuñón","Philippe Gabriel Steg","Deepak L Bhatt","Vera A Bittner","Rafael Díaz","Shaun G Goodman","J Wouter Jukema","Yong-Un Kim","Qian H Li","Christian Mueller","Alexander Parkhomenko","Robert Pordy","Piyamitr Sritara","Michael Szarek","Harvey D White","Andreas M Zeiher","Gregory G Schwartz"],"significance":7,"published":"2020-11-07","source_date":"2020-11-07","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/pcsk9-remmers-evolocumab-alirocumab/"],"congress":"","summary_en":"This ODYSSEY OUTCOMES analysis showed that alirocumab reduces MACE consistently across the spectrum of renal function after ACS, supporting PCSK9 inhibitor use regardless of CKD status.","created":"2026-07-03T10:28:52Z","updated":"2026-07-03T13:28:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"ODYSSEY OUTCOMES analyse naar het effect van alirocumab op MACE gestratificeerd naar nierfunctie na ACS.","abstract_original":"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."}