Future myocardial infarction after an acute coronary syndrome and pharmacogenetic response to dalcetrapib - Summary - MDSpire

Future myocardial infarction after an acute coronary syndrome and pharmacogenetic response to dalcetrapib

  • By

  • Jean-Claude Tardif

  • Marc A Pfeffer

  • Simon Kouz

  • Wolfgang Koenig

  • Aldo P Maggioni

  • John J V McMurray

  • David D Waters

  • J Wouter Jukema

  • Harvey D White

  • Therese Heinonen

  • David Kallend

  • Fouzia Laghrissi-Thode

  • Valtteri Muroke

  • Annik Fortier

  • Marie-Claude Guertin

  • Marie-Pierre Dubé

  • for the dal-GenE Investigators

  • October 14, 2025

  • 0 min

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Objective:

To identify risk factors for future myocardial infarction (MI) in acute coronary syndrome (ACS) survivors and evaluate the efficacy of dalcetrapib in reducing MI risk in genetically defined patients, particularly focusing on pharmacogenetic responses.

Key Findings:
  • 18 out of 36 baseline variables were identified as significant risk markers for future MI, achieving a Harrell C-index of 0.72 [95% CI, 0.69–0.75].
  • Key predictors included prior coronary events, LDL-cholesterol, blood pressure, A1c, hs-CRP, smoking, and age.
  • In AA genotype patients, the hazard ratio for MI was 1.92 [95% CI, 1.78–2.08] for each standard deviation increase in the prediction index.
  • Dalcetrapib reduced the risk of MI by 23% compared to placebo, with a hazard ratio of 0.77 [95% CI, 0.63–0.94].
Interpretation:

Despite guideline-directed therapy, traditional risk factors remain significant in predicting future MI in ACS survivors, highlighting the need for continued focus on these factors even as new therapies like dalcetrapib are evaluated.

Limitations:
  • The study's findings are based on data from two clinical trials, which may limit generalizability.
  • The prediction index requires further validation in diverse populations, and potential biases in trial populations may affect the applicability of results.
Conclusion:

The study highlights the importance of traditional risk factors in predicting MI risk in ACS survivors and suggests that dalcetrapib may provide additional benefits in genetically selected patients.

Original Source(s)

Future myocardial infarction after an acute coronary syndrome and pharmacogenetic response to dalcetrapib

  • by Jean-Claude Tardif, Marc A Pfeffer, Simon Kouz, Wolfgang Koenig, Aldo P Maggioni, John J V McMurray, David D Waters, J Wouter Jukema, Harvey D White, Therese Heinonen, David Kallend, Fouzia Laghrissi-Thode, Valtteri Muroke, Annik Fortier, Marie-Claude Guertin, Marie-Pierre Dubé, for the dal-GenE Investigators

  • October 14, 2025

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