Evidence map›Paper›PMID 31121022›Full record

Trial reportEuropean heart journal2019

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial.

Harvey D White, Ph Gabriel Steg, Michael Szarek, Deepak L Bhatt, Vera A Bittner, Rafael Diaz, Jay M Edelberg, Andrejs Erglis, Shaun G Goodman, Corinne Hanotin and 12 more

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed
7.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 68 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Trial
  4. Article
  5. Observational
  6. Reducing the risk of heart attack: the key role of lipid profiling and atherosclerosis imaging.European heart journal supplements : journal of the European Society of Cardiology · 2025
    Article
  7. Review
  8. Article
  9. Safety of the PCSK9 inhibitor alirocumab: insights from 47 296 patient-years of observation.European heart journal. Cardiovascular pharmacotherapy · 2024
    Review
  10. Neutrophil lymphocyte ratio and heart type fatty acid binding protein as a prognostic marker in Myocardial infarction within 48 h of admission.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2024
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Observational
  17. Article
  18. Acute coronary syndromes.Lancet (London, England) · 2022
    Review
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors at 19 institutions in 10 countries.

Harvey D WhiteGreen Lane Cardiovascular Services, Auckland City Hospital, 5 Park Road, Grafton, Auckland, New Zealand.
Ph Gabriel StegFACT (French Alliance for Cardiovascular Trials), an F-CRIN network, Département Hospitalo-Universitaire FIRE, AP-HP, Hôpital Bichat, Université Paris-Diderot, Sorbonne Paris-Cité, INSERM U-1148, 46 rue Henri Huchard, Paris, France.
Michael SzarekDepartment of Epidemiology and Biostatistics, SUNY Downstate Medical Center School of Public Health, 450 Clarkson Avenue, Brooklyn, USA.
Deepak L BhattBrigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, 75 Francis Street, Boston, USA.
Vera A BittnerDivision of Cardiovascular Disease, University of Alabama at Birmingham, 701 19th Street South - LHRB 310, Birmingham, USA.
Rafael DiazEstudios Cardiológicos Latinoamérica, Instituto Cardiovascular de Rosario, Paraguay 160, Rosario, Santa Fe, Argentina.
Jay M EdelbergSanofi, 55 Corporate Drive, Bridgewater, USA.
Andrejs ErglisLatvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, University of Latvia, Pilsonu Street 13, Riga, Latvia.
Shaun G GoodmanCanadian VIGOUR Centre, 2-132 Li Ka Shing Centre for Health Research Innovation University of Alberta, Edmonton, Alberta, Canada.
Corinne HanotinSanofi, 54-56 Rue la Boétie, Paris, France.
Robert A HarringtonStanford Center for Clinical Research, Department of Medicine, 300 Pasteur Drive, S-102, Stanford, CA, USA.
J Wouter JukemaDepartment of Cardiology, Leiden University Medical Center, RC Leiden, The Netherlands.
Renato D LopesDuke Clinical Research Institute, 200 Morris Street, Durham, NC, USA.
Kenneth W MahaffeyDepartment of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Grant S-102, Stanford, CA, USA.
Angele MoryusefSanofi, 55 Corporate Drive, Bridgewater, USA.
Robert PordyRegeneron Pharmaceuticals, 777 Old Saw Mill River Road, Tarrytown, NY, USA.
Matthew T RoeDuke Clinical Research Institute, 200 Morris Street, Durham, NC, USA.
Piyamitr SritaraDepartment of Medicine, Faculty of Medicine, Ramathibodi Hospital/Mahidol University, Rama VI Road, Thailand.
Pierluigi TricociCSL Behring, 1100 N Miami Blvd Ste 613, Durham, NC, USA.
Andreas M ZeiherDepartment of Medicine III, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main, Germany.
Gregory G SchwartzDivision of Cardiology, University of Colorado School of Medicine, 1700 N. Wheeling Street, Aurora, CO, USA.
ODYSSEY OUTCOMES Investigators
Clinical Research Institute · USSanofi (United States) · USAuckland City Hospital · NZBrigham and Women's Hospital · USCenter for Clinical Research (United States) · USCSL (United States) · USGoethe University Frankfurt · DEInserm · FRInstituto Cardiovascular de Rosario · ARLeiden University Medical Center · NLMahidol University · THPauls Stradiņš Clinical University Hospital · LVRegeneron (United States) · USSanofi (France) · FRStanford University · USSt. Michael's Hospital · CASUNY Downstate Health Sciences University · USUniversity of Alabama at Birmingham · USUniversity of Colorado Denver · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin-kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. METHODS AND

resultsMedian follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77-0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77-0.99; P = 0.032) and Type 2 (0.77, 0.61-0.97; P = 0.025), but not Type 4 MI.

conclusionAfter ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.

Indexed as

AgedAntibodies, Monoclonal, HumanizedCholesterol, LDLDouble-Blind MethodFemaleHumansMaleMiddle AgedMyocardial InfarctionProspective StudiesalirocumabAntibodies, Monoclonal, HumanizedCholesterol, LDLAlirocumabMI typesMortalityPrevention

Identifiers

PMID31121022
PMCPMC6736383
OpenAlexW2946105917

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.