Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p

Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial

Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402

History of the Creation and Development of M. Nodia Institute of Geophysics, TSU

წარმოდგენილია ინფორმაცია ივანე ჯავახიშვილის სახელობის თბილისის სახელმწიფო უნივერსიტეტის მიხეილ ნოდიას სახელობის გეოფიზიკის ინსტიტუტის შექმნისა და 85 წლის საქმიანობის შესახებ.Information on the history of the creation and 85 years of activity of the Mikheil Nodia Institute of Geophysics of Ivane Javakhishvili Tbilisi State University is presented

Georgia, Guria Region, Fragmentary Georadar Survey of the Former Territory of the Soviet Union Research Institute of Radiation Plant Agronom

In Georgia, in the Guria region, the territory with signs of radioactive contamination was surveyed by the GPR method. Interpretation of crossed GPR profiles for possible subsurface underground objects revealed the existence of simple and mixed burial grounds

International Scientific Conference “Modern Problems Of Ecology” Kutaisi, 21-22 September, 2018

Представлена информация о международной научная конференции“СОВРЕМЕННЫЕ ПРОБЛЕМЫ ЭКОЛОГИИ”, которая была проведена в Кутаиси, 21-22 сентября 2018 г. Конференция была посвящена 100-летию основания Тбилисского государственного университета им. Ив. Джавахишвили, 85-летию основания Государственного университета им. А. Церетели и 85-летию основания Института геофизики им. М.З. Нодиа Тбилисского государственного университета им. Ив. Джавахишвили

Research of the bioclimatic potential of Georgia in the joint works of the institutes of hydrometeorology and geophysics

წარმოდგენილია საქართველოს ბიოკლიმატური პოტენციალის შესწავლის შედეგების მოკლე მიმოხილვა სტუ-ს ჰიდრომეტეოროლოგიის და თსუ-ს გეოფიზიკის ინსტიტუტების ერთობლივ მუშაობაში ბოლო 15 წლის განმავლობაში. კერძოდ, წარმოდგენილია მონაცემები ისეთი ბიოკლიმატური პარამეტრების სივრცით-დროითი მახასიათებლების შესახებ, როგორიცაა ჰაერის ეფექტური ტემპერატურა, ტურიზმის კლიმატური ინდექსი, დასვენების კლიმატური ინდექსი.A brief review of the results of the study of the bioclimatic potential of Georgia in joint works of the institutes of hydrometeorology, GTU and geophysics, TSU over the past 15 years is presented. In particular, data on spatio-emporal characteristics of such bioclimatic parameters as air effective temperature, Tourism Climate Index, Holiday Climate Index are presented

The Magnetic Field and Magnetism of the Sand in the Black Sea Coastline

As a result of the geomagnetic studies in the Black Sea coastline (the river Natanebi, the boundary of the municipalities of Lanchkhuti and Poti) we determined the boundaries of the magnetic field and the limits of magnetic absorbability variation of the sand distributed on the territory. In the sand samples we defined the percent composition of ferromagnetic minerals. The results of the studies prove the assumption of the magnetic genesis of the Black Sea

Influence of Variations of the Annual Intensity of Galactic Cosmic Rays on the Mortality of the Population of Georgia

Results of study of influence of variations of the annual intensity of neutron component of galactic cosmic rays on the mortality of the population of Georgia in 1995-2014 are presented. In particular, the previously obtained results on a direct correlation between the intensity of cosmic rays and total mortality of the population have been confirmed. However, as it turned out, an increase in the intensity of cosmic rays mainly increases the mortality rate of the male part of the population of Georgia. The mortality rate of women is very weakly dependent to the galactic cosmic rays influence

Vertical Electrical Sounding and Georadiolocation to Assess Landslide Area Water Saturation

The vertical electrical sensing method is effectively used by studying landslides. The georadiolocation method is also a powerful tool for studying structure and watering at shallow depths. The paper presents a brief analysis of the landslide works carried out in 2021 on Machavariani Street in Tbilisi. For the landslide study the methods of vertical electrical sounding and ground penetrating radar were used. Together, these two methods yielded reliable results at different search depths, which was additionally confirmed during the drilling process

Исследования изменения климата в Грузии в совместных работах институтов географии и геофизики

გამოკვლევულია ატმოსფეროში აეროზოლური დაბინძურების, ღრუბლიანობის, ნისლების, ოზონის საერთო რაოდენობის და სხვ. მრავალწლიანი დინამიკა; შესწავლილია ატმოსფეროს აეროზოლური დაბინძურების ზეგავლენა მზის რადიაციის, ღრუბლიანობის, ნისლების და სხვ. ცვალებადობაზე. შეფასებულია ზოგიერთი კლიმატის ელემენტების მოსალოდნელი ცვლილება. გათვალისწინებულია აღნიშნული ერთობლივი გამოკვლევების გაგრძელება და აგრეთვე ძალების გაერთიანება ახალი სამეცნიერო და გამოყენებითი მნიშვნელობის ამოცანების გადასაწყვეტად