Evidence map›Paper›PMID 33051646›Full record

Trial reportEuropean heart journal2020

Lipoprotein(a) lowering by alirocumab reduces the total burden of cardiovascular events independent of low-density lipoprotein cholesterol lowering: ODYSSEY OUTCOMES trial.

Michael Szarek, Vera A Bittner, Philip Aylward, Marie Baccara-Dinet, Deepak L Bhatt, Rafael Diaz, Zlatko Fras, Shaun G Goodman, Sigrun Halvorsen, Robert A Harrington and 13 more

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 4 pooled it
25.9field-weighted citation impact, top 1% 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

91 citing papers in PubMed, 4 syntheses or guidelines pooled it, 196 citations in OpenAlex.

  1. Pooled it
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  11. Article
  12. Novel Lipoprotein (a) Therapies: A Comprehensive Review.Current atherosclerosis reports · 2026
    Review
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  20. Lipoprotein(a) Lowering with Pelacarsen (TQJ230).Cardiovascular & hematological disorders drug targets · 2026
    Review

31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors at 20 institutions in 13 countries.

Michael SzarekDepartment of Epidemiology and Biostatistics, State University of New York, Downstate School of Public Health, 450 Clarkson Avenue, MS 43, Brooklyn, NY 11203, USA.
Vera A BittnerDivision of Cardiovascular Disease, University of Alabama at Birmingham, 701 19th Street South - LHRB 310, Birmingham, AL 35294, USA.
Philip AylwardDepartment of Cardiology, South Australian Health and Medical Research Institute, Flinders University and Medical Centre, South Australia 5042, Australia.
Marie Baccara-DinetSanofi R&D, Global Development, 371 Rue du Professeur Blayac, 34080 Montpellier, France.
Deepak L BhattDepartment of Medicine, Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Rafael DiazEstudios Clínicos Latinoamérica, Instituto Cardiovascular de Rosario, Paraguay 160, Rosario, Santa Fe, Rosario 2000, Argentina.
Zlatko FrasPreventive Cardiology Unit, Department of Vascular Medicine, Division of Medicine, University Medical Centre Ljubljana, Zaloška cesta 7, SI-1525 Ljubljana, Slovenia.
Shaun G GoodmanCanadian VIGOUR Centre, University of Alberta, 87 Ave NW, Edmonton, Alberta T6G 2E1, Canada.
Sigrun HalvorsenDepartment of Cardiology, Oslo Universitetssykehus HF Ulleval, and University of Oslo, Problemveien 7, 0315 Oslo, Norway.
Robert A HarringtonStanford Center for Clinical Research, Department of Medicine, Stanford University, 291 Campus Drive, Li Ka Shing Building, Stanford, CA 94305-5101, USA.
J Wouter JukemaDepartment of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
Patrick M MoriartyClinical Pharmacology-University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
Robert PordyRegeneron Pharmaceuticals, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA.
Kausik K RayImperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, Imperial College London, Reynolds Building, St Dunstans Road, London W6 8RP, UK.
Peter SinnaeveDepartment of Cardiovascular Medicine, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium.
Sotirios TsimikasSulpizio Cardiovascular Center, Division of Cardiovascular Medicine, University of California San Diego, 9434 Medical Center Dr, La Jolla, CA 92037, USA.
Robert VogelDepartment of Medicine, University of Colorado Denver, 13001 E 17th Pl, Aurora, CO 80045, USA.
Harvey D WhiteGreen Lane Cardiovascular Services, Auckland City Hospital, 5 Park Road, Grafton, Auckland 1142, New Zealand.
Doron ZahgerDepartment of Cardiology, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, PO Box 151 Beer Sheva 8410, Israel.
Andreas M ZeiherDepartment of Medicine III, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany.
Ph Gabriel StegUniversité de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Université de Paris, FACT (French Alliance for Cardiovascular Trials), INSERM U1148, 46 Rue Henri Huchard, Paris 75018, France.
Gregory G SchwartzDivision of Cardiology, University of Colorado School of Medicine, Box B130, Aurora, CO 80045, USA.
ODYSSEY OUTCOMES Investigators
University of Colorado Denver · USAuckland City Hospital · NZBen-Gurion University of the Negev · ILBrigham and Women's Hospital · USCenter for Clinical Research (United States) · USEstudios Clínicos Latinoamérica · ARFlinders University · AUGoethe University Frankfurt · DEImperial College London · GBInserm · FRKU Leuven · BELeiden University Medical Center · NLRegeneron (United States) · USSanofi (France) · FRState University of New York · USSt. Michael's Hospital · CAUniversity of Alabama at Birmingham · USUniversity of California San Diego · USUniversity of Kansas Medical Center · USUniversity of Ljubljana · SI

Funding

University of Alabama at Birmingham's Diabetes Research CenterP30DK079626 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Kirk Michael Habegger · 2013 to 2026
$19.5M
NIDDK NIH HHS P30 DK079626
6 · The paper itself

Abstract

aimsLipoprotein(a) concentration is associated with first cardiovascular events in clinical trials. It is unknown if this relationship holds for total (first and subsequent) events. In the ODYSSEY OUTCOMES trial in patients with recent acute coronary syndrome (ACS), the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab reduced lipoprotein(a), low-density lipoprotein cholesterol (LDL-C), and cardiovascular events compared with placebo. This post hoc analysis determined whether baseline levels and alirocumab-induced changes in lipoprotein(a) and LDL-C [corrected for lipoprotein(a) cholesterol] independently predicted total cardiovascular events. METHODS AND

resultsCardiovascular events included cardiovascular death, non-fatal myocardial infarction, stroke, hospitalization for unstable angina or heart failure, ischaemia-driven coronary revascularization, peripheral artery disease events, and venous thromboembolism. Proportional hazards models estimated relationships between baseline lipoprotein(a) and total cardiovascular events in the placebo group, effects of alirocumab treatment on total cardiovascular events by baseline lipoprotein(a), and relationships between lipoprotein(a) reduction with alirocumab and subsequent risk of total cardiovascular events. Baseline lipoprotein(a) predicted total cardiovascular events with placebo, while higher baseline lipoprotein(a) levels were associated with greater reduction in total cardiovascular events with alirocumab (hazard ratio Ptrend = 0.045). Alirocumab-induced reductions in lipoprotein(a) (median -5.0 [-13.6, 0] mg/dL) and corrected LDL-C (median -51.3 [-67.1, -34.0] mg/dL) independently predicted lower risk of total cardiovascular events. Each 5-mg/dL reduction in lipoprotein(a) predicted a 2.5% relative reduction in cardiovascular events.

conclusionBaseline lipoprotein(a) predicted the risk of total cardiovascular events and risk reduction by alirocumab. Lipoprotein(a) lowering contributed independently to cardiovascular event reduction, supporting the concept of lipoprotein(a) as a treatment target after ACS.

Indexed as

Anticholesteremic AgentsHydroxymethylglutaryl-CoA Reductase InhibitorsAntibodies, Monoclonal, HumanizedCholesterolCholesterol, LDLHumansLipoprotein(a)Proprotein Convertase 9Treatment OutcomealirocumabAntibodies, Monoclonal, HumanizedAnticholesteremic AgentsCholesterolCholesterol, LDLHydroxymethylglutaryl-CoA Reductase InhibitorsLipoprotein(a)Proprotein Convertase 9Acute coronary syndromeAlirocumabLDLLipoprotein

Identifiers

PMID33051646
PMCPMC7724642
OpenAlexW3092288248

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.