Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia
Deepak L Bhatt1, P Gabriel Steg1, Michael Miller1
1From Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston (D.L.B.); FACT (French Alliance for Cardiovascular Trials), Département Hospitalo-Universitaire FIRE (Fibrose, Inflammation, and Remodeling), Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Université Paris-Diderot, INSERM Unité 1148, Paris (P.G.S.); National Heart and Lung Institute, Imperial College, Royal Brompton Hospital, London (P.G.S.); the Department of Medicine, University of Maryland School of Medicine, Baltimore (M.M.); the Utah Lipid Center, Salt Lake City (E.A.B.); the Office of Health Promotion and Disease Prevention, Department of Medicine, Emory University School of Medicine, Atlanta (T.A.J.); Amarin Pharma, Bedminster, NJ (S.B.K., R.T.D.J., R.A.J., L.J., C.G.); Montreal Heart Institute, Université de Montréal, Montreal (J.-C.T.); and the Department of Medicine, Baylor College of Medicine, and the Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston (C.M.B.).
Icosapent ethyl significantly reduced ischemic events and cardiovascular death in patients with high triglycerides on statin therapy. This highly purified eicosapentaenoic acid ethyl ester offers a new therapeutic option for cardiovascular risk reduction.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Elevated triglyceride levels are a known risk factor for ischemic events.
- Icosapent ethyl, a purified eicosapentaenoic acid ethyl ester, is known to lower triglycerides.
- Further data were needed to confirm its impact on ischemic events.
Purpose of the Study:
- To evaluate the efficacy of icosapent ethyl in reducing ischemic events in high-risk patients.
- To assess the impact of icosapent ethyl on cardiovascular death, myocardial infarction, and stroke.
Main Methods:
- A multicenter, randomized, double-blind, placebo-controlled trial was conducted.
- 8179 patients with cardiovascular disease or diabetes and risk factors, on statin therapy, were enrolled.
- Patients received either 2g icosapent ethyl twice daily or placebo for a median of 4.9 years.
Main Results:
- Icosapent ethyl significantly reduced the primary composite end point (ischemic events) by 25% (HR 0.75, P<0.001).
- The key secondary end point (cardiovascular death, MI, stroke) was reduced by 26% (HR 0.74, P<0.001).
- Cardiovascular death was reduced by 20% (HR 0.80, P=0.03), with increased hospitalization for atrial fibrillation.
Conclusions:
- In high-triglyceride patients on statins, icosapent ethyl significantly lowered the risk of ischemic events, including cardiovascular death.
- Icosapent ethyl represents a valuable therapeutic strategy for reducing cardiovascular risk in this patient population.
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