Figure 4.

Spline analyses of continuous TWMA LDL-C in the alirocumab group. Hazard ratio (dashed lines represent upper and lower bounds of 95% CI) is relative to 50 mg/dL. Degree = 3, 3 knots located at LDL-C quartiles (62.5, 42.8, 31.8). P<0.0001 for spline effects. The risk of MACE decreased with decreasing TWMA LDL-C to a nadir at ≈23 mg/dL, without evidence of a further decrease in risk of MACE below that LDL-C level. Note that this analysis is limited to the alirocumab group and is unadjusted, and patients with lower achieved LDL-C were at lower risk for MACE for reasons in addition to their achieved LDL-C. Therefore, a nadir of MACE at ≈23 mg/dL should be interpreted cautiously and does not necessarily imply the optimal achieved LDL-C level in all patients. LDL-C indicates low-density lipoprotein cholesterol; MACE, major adverse cardiovascular events; and TWMA, time-weighted moving average.