Icosapent ethyl substantially decreases the burden of first, subsequent, and total ischemic events in patients treated with statins with elevated triglycerides and established cardiovascular (CV) disease or diabetes, according to study results published in the Journal of the American College of Cardiology.
Even though statin therapy has had a tremendous effect on primary and secondary prevention, ischemic events still occur in patients with CV risk factors such as elevated triglycerides, atherosclerosis, or diabetes. Such patients are at risk for an initial event as well as subsequent events, which can be fatal.
Icosapent ethyl reduces triglyceride levels and other lipids and lipoproteins without increasing low-density lipoprotein cholesterol (LDL-C), thus reducing the first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or hospitalization for unstable angina.
Researchers sought to determine the effect of icosapent ethyl on total ischemic events (first and subsequent events) to better characterize the totality of the ischemic event burden across the overall study population.
Using prespecified analyses in 8179 patients treated with statins with triglycerides ≥135 and <500 mg/dL and LDL-C >40 and ≤100 mg/dL and a history of atherosclerosis (71% of patients) or diabetes (29%) randomly assigned to receive either icosapent ethyl 4 g/d or placebo, they found that 1606 (55.2%) had first primary end point events and 1303 (44.8%) had subsequent primary end point events over a median of 4.9 years.
Overall, icosapent ethyl reduced total primary end point events by 61/1000 patient-years compared with 89/1000 patient-years with placebo (P <.0001). In addition, icosapent ethyl reduced each primary end point component, including CV death, and total key secondary end point events.
“In conclusion, icosapent ethyl [4 g] daily ([2 g] twice daily) significantly
reduces total ischemic events in statin-treated patients with well-controlled LDL-C and
[CV] risk factors including elevated triglycerides,” stated the investigators.
Bhatt DL, Steg PG, Miller M, et al. Effects of icosapent ethyl on total ischemic events: From REDUCE-IT [published online March 18, 2019]. J Am Coll Cardiol. doi:10.1016/j.jacc.2019.02.032