Evidence map›Paper›PMID 33755142›Full record

ArticleEuropean journal of preventive cardiology2021

Eligibility for PCSK9 inhibitors based on the 2019 ESC/EAS and 2018 ACC/AHA guidelines.

Konstantinos C Koskinas, Baris Gencer, David Nanchen, Mattia Branca, David Carballo, Roland Klingenberg, Manuel R Blum, Sebastian Carballo, Olivier Muller, Christian M Matter and 7 more

2 registry-linked trialsAbstract read
PubMed Publisher
In one paragraph

Article in European journal of preventive cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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.

NCT06520904 phase4recruitingstarted 2024, after this paper: background citation

Effect of PCSK9 Inhibitors on Coronary Atherosclerotic Plaques Derived From Optical Coherence Tomography in Patients With Premature Coronary Artery Disease: a Randomized Controlled Trial

Ran2024Enrolled396Registered outcomes6Posted comparisons0ConditionsCoronary Artery Disease, Optical Coherence TomographyArmsPCSK9 inhibitor, Statin
Open the trial in the graph
NCT05844566 nacompletednot on this mapstarted 2023, after this paper: background citation

Implementation of a Decision Support System and Its Effect on Early Optimisation of Lipid-Lowering Therapies in Patients With Acute Coronary Syndrome: a Cluster Randomised Controlled Trial

TypeinterventionalSponsorImperial College LondonRan2023 to 2024Enrolled1,139ConditionsAcute Coronary Syndrome, Myocardial InfarctionArmsDecision Support System (DSS)
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Lipid Lowering Drugs in Acute Coronary Syndromes (ACS).Current atherosclerosis reports · 2023
    Review
  9. In-hospital initiation of PCSK9 inhibitors in ACS: pros and cons.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023
    Article
  10. Article
  11. Article
  12. Article
  13. Near-infrared spectroscopy to predict plaque progression in plaque-free artery regions.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2022
    Article
  14. Is it Time for Single-Pill Combinations in Dyslipidemia?American journal of cardiovascular drugs : drugs, devices, and other interventions · 2022
    Review
  15. Lipid-lowering therapy and percutaneous coronary interventions.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021
    Review
  16. Review
  17. Review
  18. Safety and Tolerability of PCSK9 Inhibitors: Current Insights.Clinical pharmacology : advances and applications · 2020
    Review
  19. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Konstantinos C KoskinasDepartment of Cardiology, University Hospital Bern, Switzerland.
Baris GencerDivision of Cardiology, Geneva University Hospital, Switzerland.
David NanchenDepartment of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland.
Mattia BrancaClinical Trials Unit Bern, University of Bern, Switzerland.
David CarballoDivision of Cardiology, Geneva University Hospital, Switzerland.
Roland KlingenbergDepartment of Cardiology, University Hospital Zurich, Switzerland.
Manuel R BlumDepartment of General Internal Medicine, Bern University Hospital, Switzerland.
Sebastian CarballoService of Internal Medicine, Geneva University Hospital, Switzerland.
Olivier MullerService of Cardiology, Lausanne University Hospital, Switzerland.
Christian M MatterDepartment of Cardiology, University Hospital Zurich, Switzerland.
Thomas F LüscherRoyal Brompton and Harefield Hospital Trust and Imperial College, UK.
Nicolas RodondiDepartment of General Internal Medicine, Bern University Hospital, Switzerland.
Dik HegClinical Trials Unit Bern, University of Bern, Switzerland.
Matthias WilhelmDepartment of Cardiology, University Hospital Bern, Switzerland.
Lorenz RäberDepartment of Cardiology, University Hospital Bern, Switzerland.
François MachDivision of Cardiology, Geneva University Hospital, Switzerland.
Stephan WindeckerDepartment of Cardiology, University Hospital Bern, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe 2018 American College of Cardiology (ACC)/American Heart Association (AHA) and 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) lipid guidelines recently updated their recommendations regarding proprotein convertase subtilisin/kexin-9 inhibitors (PCSK9i). We assessed the potential eligibility for PCSK9i according to the new guidelines in patients with acute coronary syndromes. METHODS AND

resultsWe analysed a contemporary, prospective Swiss cohort of patients hospitalised for acute coronary syndromes. We modelled a statin intensification effect and an incremental ezetimibe effect on low-density lipoprotein-cholesterol levels among patients who were not on high-intensity statins or ezetimibe. One year after the index acute coronary syndrome event, treatment eligibility for PCSK9i was defined as low-density lipoprotein-cholesterol of 1.4 mmol/l or greater according to ESC/EAS guidelines. For ACC/AHA guidelines, treatment eligibility was defined as low-density lipoprotein-cholesterol of 1.8 mmol/l or greater in the presence of very high-risk atherosclerotic cardiovascular disease, defined by multiple major atherosclerotic cardiovascular disease events and/or high-risk conditions. Of 2521 patients, 93.2% were treated with statins (53% high-intensity statins) and 7.3% with ezetimibe at 1 year, and 54.9% had very high-risk atherosclerotic cardiovascular disease. Low-density lipoprotein-cholesterol levels less than 1.8 mmol/l and less than 1.4 mmol/l at 1 year were observed in 37.5% and 15.7% of patients, respectively. After modelling the statin intensification and ezetimibe effects, these numbers increased to 76.1% and 49%, respectively. The proportion of patients eligible for PCSK9i was 51% according to ESC/EAS criteria versus 14% according to ACC/AHA criteria.

conclusionsIn this analysis, the 2019 ESC/EAS guidelines rendered half of all post-acute coronary syndrome patients potentially eligible for PCSK9i treatment, as compared to a three-fold lower eligibility rate based on the 2018 ACC/AHA guidelines.

Indexed as

AtherosclerosisCardiologyCardiovascular DiseasesHydroxymethylglutaryl-CoA Reductase InhibitorsPCSK9 InhibitorsEuropeHumansPractice Guidelines as TopicProprotein Convertase 9Prospective StudiesSocieties, MedicalUnited StatesHydroxymethylglutaryl-CoA Reductase InhibitorsPCSK9 InhibitorsPCSK9 protein, humanProprotein Convertase 9ezetimibeLipidsPCSK9 inhibitorssecondary preventionstatins

Identifiers

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

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.