Trial reportEuropean heart journal2022
Alirocumab after acute coronary syndrome in patients with a history of heart failure.
Trial report in European heart journal, 2022. The graph read 1 number from its abstract, feeding 1 cell of the map: it supports the treatment in 1. Cited by 16 papers, 2 of them syntheses that pooled 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.
Overall, alirocumab reduced MACE compared with placebo [hazard ratio (HR): 0.85; 95% confidence interval (CI): 0.78-0.93; P = 0.0001].
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Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
PCSK9 inhibitors×cardiovascular events
SupportsOpen on the map →What to test next →10 readable studies in this cell: 7 favour the treatment, 3 find no difference, 0 favour the comparator.
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.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Lipoprotein(a) and heart failure: a systematic review.Heart failure reviews · 2023Pooled it
- Is a PCSK9 Inhibitor Right for Your Patient? A Review of Treatment Data for Individualized Therapy.International journal of environmental research and public health · 2022Pooled it
- Impact of Icosapent Ethyl on Cardiovascular Risk Reduction in Patients With Heart Failure in REDUCE-IT.Journal of the American Heart Association · 2022Trial
- Management of dyslipidaemia in patients with comorbidities-facing the challenge: heart failure.European heart journal. Cardiovascular pharmacotherapy · 2026Review
- Can LDL-C be too low? Time to rethink the "lower is better" paradigm.Internal and emergency medicine · 2026Article
- Lipoprotein(a): A Novel Risk Factor for Heart Failure and Biomarker of Prognosis? From Pathophysiology to Clinical Practice.Cardiac failure review · 2026Review
- Brazilian Guideline on Dyslipidemias and Prevention of Atherosclerosis - 2025.Arquivos brasileiros de cardiologia · 2025Article
- LDL cholesterol and clinical outcomes in heart failure with reduced ejection fraction a competing risk analysis.Scientific reports · 2025Article
- Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9): The Multifaceted Biology, Diseases, and Pharmaceutical Interventions.MedComm · 2025Review
- Review
- Molecular remodeling in comorbidities associated with heart failure: a current update.Molecular biology reports · 2024Review
- Proteome-wide mendelian randomization investigates potential associations in heart failure and its etiology: emphasis on PCSK9.BMC medical genomics · 2024Article
- Residual cardiovascular disease risk in heart failure patients. What is the real role of lipid-lowering therapy?Archives of medical science : AMS · 2024Article
- Effect of PCSK9 on atherosclerotic cardiovascular diseases and its mechanisms: Focus on immune regulation.Frontiers in cardiovascular medicine · 2023Review
- Predictive value of remnant cholesterol level for all-cause mortality in heart failure patients.Frontiers in cardiovascular medicine · 2023Article
- PCSK9 Monoclonal Antibodies: New Developments and Their Relevance in a Nucleic Acid-Based Therapy Era.Current atherosclerosis reports · 2022Review
Corrections and comments
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Authors and funding
17 authors at 14 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
aimsPatients with heart failure (HF) have not been shown to benefit from statins. In a post hoc analysis, we evaluated outcomes in ODYSSEY OUTCOMES in patients with vs. without a history of HF randomized to the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab or placebo. METHODS AND
resultsAmong 18 924 patients with recent acute coronary syndrome (ACS) receiving intensive or maximum-tolerated statin treatment, the primary outcome of major adverse cardiovascular events (MACE) was compared in patients with or without a history of HF. The pre-specified secondary outcome of hospitalization for HF was also analysed. Overall, 2815 (14.9%) patients had a history of HF. Alirocumab reduced low-density lipoprotein cholesterol and lipoprotein(a) similarly in patients with or without HF. Overall, alirocumab reduced MACE compared with placebo [hazard ratio (HR): 0.85; 95% confidence interval (CI): 0.78-0.93; P = 0.0001]. This effect was observed among patients without a history of HF (HR: 0.78; 95% CI: 0.70-0.86; P < 0.0001), but not in those with a history of HF (HR: 1.17; 95% CI: 0.97-1.40; P = 0.10) (Pinteraction = 0.0001). Alirocumab did not reduce hospitalization for HF, overall or in patients with or without prior HF.
conclusionAlirocumab reduced MACE in patients without a history of HF but not in patients with a history of HF. Alirocumab did not reduce hospitalizations for HF in either group. Patients with a history of HF are a high-risk group that does not appear to benefit from PCSK9 inhibition after ACS.
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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 Socratic graph.