Author + information
- Peter P. Toth,
- Naveed Sattar,
- Dirk Blom,
- Seth Martin,
- Steven Jones,
- Maria Laura Monsalvo,
- Mary Elliott,
- Ransi Somaratne and
- David Preiss
Background: Significant residual risk for cardiovascular events remains when LDL cholesterol (LDL-C) levels are low but other atherogenic lipoproteins in serum are not (discordance). One way to assess concordance/discordance between two analytes is to establish whether they are above or below a specific percentile for a given population. In this analysis, we quantified the impact of evolocumab on LDL-C and LDL particle number (LDL-P) when these measures were either concordant or discordant.
Methods: This is a post-hoc analysis of DESCARTES (NCT01516879), a randomized, double-blind, placebo-controlled, 52-week study of evolocumab in patients with hyperlipidemia who were stratified by risk to diet alone or atorvastatin ± ezetimibe. Discordance at baseline was defined as LDL-C and LDL-P values differing by >14 percentile units to allow approximately equal numbers of patients to be categorized as concordant or discordant. LDL-P and LDL-C were measured by NMR spectroscopy and using the Friedewald equation, respectively.
Results: Compared to placebo, evolocumab induced robust, highly significant reductions in both LDL-C and LDL-P in all groups (Table). Low levels of LDL-C and LDL-P were achieved in all evolocumab groups.
Conclusions: Among patients already treated with diet alone or atorvastatin ± ezetimibe, evolocumab therapy induced robust reductions in LDL-C and LDL-P in the setting of either concordance or discordance.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Advances in Cholesterol Measurement and Management
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1106-065
- 2017 American College of Cardiology Foundation