Risk of Incident Diabetes Related to Lipoprotein(a), LDL Cholesterol, and Their Changes With Alirocumab: Post Hoc Analyses of the ODYSSEY OUTCOMES Randomized Trial
Authors' conclusion
Baseline lipoprotein(a) was inversely associated with risk of NOD. Alirocumab-induced reductions of lipoprotein(a) and LDL-C were associated with increased and decreased risk of NOD, respectively, without net effect on NOD. Ongoing trials will determine the impact of larger and longer lipoprotein(a) reductions on NOD.
Study context
- Population
- Patients with recent acute coronary syndrome on optimized statin therapy, without diabetes at baseline782 NOD cases
- Participants
- 8,107 patients
- Comparison
- Alirocumab vs placebo; baseline Lp(a), LDL-C, insulin/HOMA-IR and their changes on alirocumab as predictors of new-onset T2D
- Primary endpoint
- New-onset T2D (NOD)
- Follow-up
- Median 2.4 years
Methodological detailslogistic regression with splines
- Logistic regression with splines
Primary result
As reported in the abstract
NOD predicted by baseline and on-alirocumab changes in lipoprotein(a) and LDL-C
Odds ratio (95% CI)
25% lipoprotein(a) reduction on alirocumab
1.12(1.01–1.23)
50% lipoprotein(a) reduction on alirocumab
1.24(1.02–1.52)
25% LDL-C reduction on alirocumab
0.88(0.80–0.97)
50% LDL-C reduction on alirocumab
0.77(0.64–0.94)
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| NOD risk, alirocumabvs placebo | 0.998 (0.860–1.158) | |
| 0.512Odds ratio (log scale) |
NOD risk, alirocumab vs placebo
- Alirocumab reduced lipoprotein(a) and LDL-C without affecting insulin or NOD risk
Original publication
Risk of Incident Diabetes Related to Lipoprotein(a), LDL Cholesterol, and Their Changes With Alirocumab: Post Hoc Analyses of the ODYSSEY OUTCOMES Randomized Trial. Diabetes Care. Published 6 February 2025. doi:10.
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