The objective of this study is to investigate the effectiveness of in-hospital initiation of alirocumab combined with statin ± ezetimibe on major cardiovascular events (MACE) in Chinese ACS patients. The main question it aims to answer is:
whether early initiation PCKS9i in hospital could reduce recent cardiovascular event risk in Chinese ACS patients in real-world setting.
Data from CCA Database-Chest Pain Center were screened for all ACS patients from 01-Jan 2021 to 31-Dec 2023. Patients diagnosed with STEMI, NSTEMI or UA at admission were identified at the first step. Then, for intervention group, patients who received alirocumab 75mg combined with statin ± ezetimibe during the ACS hospitalization (including the discharge date) will be included; for control group, patients who received statin ± ezetimibe during the ACS hospitalization will be included. All enrolled patients were required to have at least one documented follow-up visit.
Patients diagnosed with Acute Coronary Syndrome (ACS) upon hospital admission.
Patients aged 18 years or older.
Patients who received Alirocumab 75 mg in combination with statin therapy ± Ezetimibe as the intervention group, and those treated exclusively with statin therapy ± Ezetimibe as the control group, either during hospitalization or at discharge.
Patients with at least one follow-up record.
Patients who received Evolocumab treatment at any time.
Patients who received Inclisiran treatment at any time.
Data from CCA Database-Chest Pain Center were screened for all ACS patients from 01-Jan 2021 to 31-Dec 2023. Patients diagnosed with STEMI, NSTEMI or UA at admission were identified at the first step. Then, for intervention group, patients who received alirocumab 75mg combined with statin ± ezetimibe during the ACS hospitalization (including the discharge date) will be included; for control group, patients who received statin ± ezetimibe during the ACS hospitalization will be included. All enrolled patients were required to have at least one documented follow-up visit. Patients prescribed with evolocumab at any time will be excluded.
Cohort
Retrospective
alirocumab 75mg/2week
Drugpatients continually prescribed or stopped alirocumab treatment during the follow-up visit, which depend on physician's clinical decision and patient preference
statin ± ezetimibe
Drugpatients will be censored at initiation of alirocumab during the follow up visit
The primary endpoint is the risk of MACE within 1 year of follow-up
MACE was defined as the composite of non-fatal myocardial infarction, non-fatal ischemic stroke, all-cause mortality, or any coronary revascularization. Coronary revascularization was limited to procedures occurring at least two weeks after the index date, including PCI and CABG
Percentage reduction of LDL-C levels at 1-month follow-up from baseline
Percentage reduction of LDL-C levels at 1-month follow-up from baseline
Proportion of patient who achieved LDL-C goal (<1.4mmol/L) at 1-month follow-up
Proportion of patient who achieved LDL-C goal (\<1.4mmol/L) at 1-month follow-up
Association between ACS pathway optimization participation and MACE within 1 year follow-up
Association between ACS pathway optimization participation and MACE within 1 year follow-up
Association between ACS pathway optimization participation and LDL-C goal attainment rate at 1-month follow-up
Association between ACS pathway optimization participation and LDL-C goal attainment rate at 1-month follow-up
Percentage reduction of LDL-C levels at 3-month, 6-month follow-up from baseline (if have enough follow-up data on lab test)
Percentage reduction of LDL-C levels at 3-month, 6-month follow-up from baseline (if have enough follow-up data on lab test)
LDL-C goal attainment rate (<1.4mmol/L) at 3-month, 6-month follow-up (if have enough follow-up data on lab test)
LDL-C goal attainment rate (\<1.4mmol/L) at 3-month, 6-month follow-up (if have enough follow-up data on lab test)
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