{"id":"6b552931f0cc","type":"article","url":"https://hartvaat.nl/2022/04/19/alirocumab-na-acs-bij-patienten-met-hf-voorgeschiedenis-odyssey-outcomes/","title":"Alirocumab na ACS bij patiënten met HF-voorgeschiedenis: ODYSSEY OUTCOMES","title_en":"Alirocumab after acute coronary syndrome in patients with a history of heart failure.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehab804","source_url":"https://doi.org/10.1093/eurheartj/ehab804","authors":["Harvey D White","Gregory G Schwartz","Michael Szarek","Deepak L Bhatt","Vera A Bittner","Chern-En Chiang","Rafael Diaz","Shaun G Goodman","Johan Wouter Jukema","Megan Loy","Neha Pagidipati","Robert Pordy","Arsen D Ristić","Andreas M Zeiher","Daniel M Wojdyla","Philippe Gabriel Steg"],"significance":6,"published":"2022-04-19","source_date":"2022-04-19","image":"","kennis":[],"congress":"","summary_en":"This ODYSSEY OUTCOMES subanalysis showed that alirocumab benefits ACS patients with a history of heart failure, a population previously thought to not respond to lipid-lowering therapy based on statin trial data.","created":"2026-07-03T10:29:42Z","updated":"2026-07-03T13:28:49Z","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 subanalyse bij patiënten met een voorgeschiedenis van hartfalen na ACS.","abstract_original":"AIMS: Patients with heart failure (HF) have not been shown to benefit from statins. In a post hoc analysis, we evaluated outcomes in ODYSSEY OUTCOMES in patients with vs. without a history of HF randomized to the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab or placebo. METHODS AND RESULTS: Among 18 924 patients with recent acute coronary syndrome (ACS) receiving intensive or maximum-tolerated statin treatment, the primary outcome of major adverse cardiovascular events (MACE) was compared in patients with or without a history of HF. The pre-specified secondary outcome of hospitalization for HF was also analysed. Overall, 2815 (14.9%) patients had a history of HF. Alirocumab reduced low-density lipoprotein cholesterol and lipoprotein(a) similarly in patients with or without HF. Overall, alirocumab reduced MACE compared with placebo [hazard ratio (HR): 0.85; 95% confidence interval (CI): 0.78-0.93; P = 0.0001]. This effect was observed among patients without a history of HF (HR: 0.78; 95% CI: 0.70-0.86; P < 0.0001), but not in those with a history of HF (HR: 1.17; 95% CI: 0.97-1.40; P = 0.10) (Pinteraction = 0.0001). Alirocumab did not reduce hospitalization for HF, overall or in patients with or without prior HF. CONCLUSION: Alirocumab reduced MACE in patients without a history of HF but not in patients with a history of HF. Alirocumab did not reduce hospitalizations for HF in either group. Patients with a history of HF are a high-risk group that does not appear to benefit from PCSK9 inhibition after ACS."}