Reduction in Revascularization With Icosapent Ethyl: Insights From REDUCE-IT Revascularization Analyses

Area of Science:

• Cardiology
• Pharmacology
• Clinical Trials

Background:

• Elevated triglycerides in patients on statin therapy are associated with a higher risk of ischemic events, such as coronary revascularizations.
• Identifying effective treatments to mitigate this risk is crucial for cardiovascular disease prevention.

Purpose of the Study:

• To evaluate the efficacy of icosapent ethyl in reducing coronary revascularizations in statin-treated patients with elevated triglycerides and increased cardiovascular risk.
• To analyze the impact of icosapent ethyl on various types of revascularization procedures.

Main Methods:

• The REDUCE-IT trial was a multicenter, double-blind, placebo-controlled study involving 8179 patients.
• Patients received either icosapent ethyl (4 g/d) or placebo, in addition to statin therapy.
• Follow-up was for a median of 4.9 years, with prespecified analyses of revascularization events.

Main Results:

• Icosapent ethyl reduced first revascularizations by 34% (HR, 0.66; P<0.0001) and total revascularizations by 36% (rate ratio, 0.64; P<0.0001).
• Significant reductions were observed across elective, urgent, and emergent revascularizations, including percutaneous coronary intervention and coronary artery bypass grafting.
• The number needed to treat for 4.9 years to prevent one revascularization was 24.

Conclusions:

• Icosapent ethyl effectively reduces the need for both first and subsequent coronary revascularizations in high-risk patients with elevated triglycerides on statin therapy.
• It is the first non-low-density lipoprotein-lowering therapy demonstrated to reduce coronary artery bypass grafting in a blinded, randomized trial.