Recent Updates in Hypertriglyceridemia Management for Cardiovascular Disease Prevention

Area of Science:

• Cardiology
• Metabolic Diseases
• Pharmacology

Background:

• Triglyceride-rich lipoproteins (TRL) play a causal role in atherosclerotic cardiovascular disease (ASCVD).
• Residual ASCVD risk persists in patients with elevated triglycerides despite statin therapy for LDL-C reduction.

Purpose of the Study:

• To review current evidence on triglyceride-lowering therapies for managing hypertriglyceridemia and residual ASCVD risk.
• To evaluate the efficacy and safety of various pharmacological interventions beyond statins.

Main Methods:

• Review of randomized clinical trials and emerging research on triglyceride-lowering agents.
• Analysis of data from key trials like REDUCE-IT and studies on fibrates, apoC3, and ANGPTL3 inhibitors.

Main Results:

• Icosapent ethyl (highly purified EPA) demonstrated significant reduction in vascular events in high-risk patients.
• Fibrates show no incremental ASCVD benefit with statins but are useful for pancreatitis prevention.
• Emerging therapies like apoC3 and ANGPTL3 inhibitors show promise in reducing triglycerides and LDL-C.

Conclusions:

• High-dose icosapent ethyl offers cardiovascular benefit in statin-treated patients with elevated triglycerides and high ASCVD risk.
• Novel selective therapies targeting TRL metabolism are a promising area for future ASCVD risk reduction.
• Management of hypertriglyceridemia remains crucial for addressing residual cardiovascular risk.