- Addition of alirocumab to maximally tolerated high-intensity statins significantly reduced the risk for recurrent ischaemic events and all-cause death in patients after an acute coronary syndrome (ACS) irrespective of age and without significant safety issues in older patients.
- Absolute treatment benefit of alirocumab increased with advancing age indicating that lipid-lowering therapy beyond statins may be an important secondary preventive intervention for older patients after ACS.
Why this matters
- Findings might be considered in future guideline recommendations for lipid-lowering therapies in older patients.
- Prespecified analysis of ODYSSEY OUTCOMES compared the effect of alirocumab vs placebo in 18,924 patients with recent ACS according to age group (≥65/
- Primary outcome: major adverse cardiovascular events (MACEs; composite of death from coronary heart disease, non-fatal myocardial infarction, fatal or non-fatal ischaemic stroke, or unstable angina requiring hospitalisation).
- Funding: Sanofi and others.
- No significant difference was observed between alirocumab vs placebo in the risk for MACEs in patients aged:
- ≥65 vs interaction=.19) and
- ≥75 vs interaction=.19).
- The risk for MACE reduced with alirocumab with numbers-needed-to-treat for MACE at 3 years of 43 (range, 25-186) at age 45 years, 26 (range, 15-97) at age 75 years and 12 (range, 6-81) for those at age 85 years.
- No significant difference was observed for adverse and serious adverse events between alirocumab and placebo in patients aged ≥65 or
- Study included limited number of very elderly patients.