Author + information
- Antonio Vallejo-Vaza,b,
- Henry Ginsberga,b,
- Michael Davidsona,b,
- Robert H. Eckela,b,
- Christopher Cannona,b,
- Veronica Leea,b,
- Laurence Bessaca,b,
- Robert Pordya,b,
- Alexia Letiercea,b and
- Kausik Raya,b
Introduction: In statin trials, men and women derived similar relative risk reductions in cardiovascular disease (CVD) events for each 39 mg/dL reduction in low-density lipoprotein cholesterol (LDL-C). We explored whether lower LDL-C levels would be associated with a lower major adverse CV event (MACE) rate in women as well as in men.
Methods: Data were pooled from 10 Phase 3 ODYSSEY trials comparing alirocumab (ALI) vs placebo (PBO) or ezetimibe (EZE). Patients had established CVD or high CVD risk with uncontrolled LDL-C (most were on a maximally tolerated statin). We assessed the association between 39 mg/dL lower on-treatment LDL-C and MACE in men vs women using multivariable Cox regression.
Results: Mean baseline LDL-C was 121 mg/dL (men) and 135 mg/dL (women). Average on-treatment LDL-C levels with ALI, EZE and PBO, respectively, were 52, 93 and 122 mg/dL in men (n = 3090) and 71, 114 and 134 mg/dL in women (n = 1882). Each 39 mg/dL lower on-treatment LDL-C was associated with 22% lower risk of MACE in men (p=0.0297) and 29% lower risk in women (p=0.0459), p-heterogeneity 0.6427 (Figure). ALI was generally well-tolerated with no differences in safety in women vs men.
Conclusions: Although women in these trials had a slightly higher on-treatment LDL-C than men, both women and men showed a lower risk of MACE with lower LDL-C levels.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Cardiac Arrest, Diabetes, and Other High Risk Features of Patients With Acute Coronary Syndrome
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1204-331
- 2017 American College of Cardiology Foundation