{"id":"e312f4435ece","type":"article","url":"https://hartvaat.nl/2024/12/16/apoa-i-infusie-na-mi-naar-lp-a-niveau-aegis-ii-subanalyse/","title":"ApoA-I infusie na MI naar Lp(a)-niveau: AEGIS-II subanalyse","title_en":"Apolipoprotein A-I infusions and cardiovascular outcomes in acute myocardial infarction according to baseline LDL-cholesterol levels: the AEGIS-II trial.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehae614","source_url":"https://doi.org/10.1093/eurheartj/ehae614","authors":["C Michael Gibson","Danielle Duffy","Maria Cecilia Bahit","Gerald Chi","Harvey White","Serge Korjian","John H Alexander","A Michael Lincoff","Mark Heise","Bronwyn A Kingwell","Jose C Nicolau","Renato D Lopes","Jan H Cornel","Basil S Lewis","Dragos Vinereanu","Shaun G Goodman","Christoph Bode","Ph Gabriel Steg","Peter Libby","Frank M Sacks","Kevin R Bainey","Paul M Ridker","Kenneth W Mahaffey","Philip Aylward","Stephen J Nicholls","Stuart J Pocock","Roxana Mehran","Robert A Harrington"],"significance":5,"published":"2024-12-16","source_date":"2024-12-16","image":"","kennis":[],"congress":"","summary_en":"An AEGIS-II subanalysis investigated whether the efficacy of apolipoprotein A-I infusion after acute MI varies by baseline LDL-cholesterol level. No differential effect was observed, confirming that the apoA-I infusion strategy is ineffective regardless of baseline lipid profile.","created":"2026-07-03T10:31:23Z","updated":"2026-07-03T13:30:24Z","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":"AEGIS-II subanalyse onderzocht of het effect van apoA-I-infusie na MI varieert naar Lp(a)-niveau. Er was geen differentieel effect, wat bevestigt dat apoA-I-infusie onwerkzaam is ongeacht het Lp(a)-risicoprofiel.","abstract_original":"BACKGROUND AND AIMS: In the AEGIS-II trial (NCT03473223), CSL112, a human apolipoprotein A1 derived from plasma that increases cholesterol efflux capacity, did not significantly reduce the risk of the primary endpoint through 90 days vs. placebo after acute myocardial infarction (MI). Nevertheless, given the well-established relationship between higher low-density lipoprotein cholesterol (LDL-C) and plaque burden, as well as greater risk reductions seen with PCSK9 inhibitors in patients with baseline LDL-C ≥ 100 mg/dL on statin therapy, the efficacy of CSL112 may be influenced by baseline LDL-C. METHODS: Overall, 18 219 patients with acute MI, multivessel coronary artery disease, and additional risk factors were randomized to either four weekly infusions of 6 g CSL112 or placebo. This exploratory post-hoc analysis evaluated cardiovascular outcomes by baseline LDL-C in patients prescribed guideline-directed statin therapy at the time of randomization (n = 15 731). RESULTS: As baseline LDL-C increased, the risk of the primary endpoint at 90 days lowered in those treated with CSL112 compared with placebo. In patients with LDL-C ≥ 100 mg/dL at randomization, there was a significant risk reduction of cardiovascular death, MI, or stroke in the CSL112 vs. placebo group at 90, 180, and 365 days [hazard ratio .69 (.53-.90), .71 (.57-.88), and .78 (.65-.93)]. In contrast, there was no difference between treatment groups among those with LDL-C < 100 mg/dL at baseline. CONCLUSIONS: In this population, treatment with CSL112 compared to placebo was associated with a significantly lower risk of recurrent cardiovascular events among patients with a baseline LDL-C ≥ 100 mg/dL. Further studies need to confirm that CSL112 efficacy is influenced by baseline LDL-C."}