|Lowering triglyceride levels reduces risk of cardiovascular events|
|Elevated triglyceride levels in patients with cardiovascular risk factors who are treated for secondary or primary prevention indicates an increased susceptibility of ischemic events. Therapeutic strategies that aim to lowering triglyceride levels have demonstrated conflicting results in terms of preventing cardiovascular events. In order to determine whether icosapent ethyl (a purified and stable eicosapentaenoic acid ethyl ester) can reduce the risk of cardiovascular events, investigators conducted the REDUCE-IT trial and published their results in a recent issue of NEJM (here).
In this phase 3b randomized, double-blind, placebo-controlled trial, patients who were 45 years of age or older and had a history of cardiovascular disease, or who were 50 years of age or older and had diabetes mellitus and at least one additional risk factor, were recruited. Eligible patients had a fasting triglyceride level of 150 to 499 mg/dL and a low-density lipoprotein cholesterol level of 41 to 100 mg/dL. All patients received statin treatment. A total of 4089 patients were assigned to the icosapent ethyl group receiving 2 g of icosapent ethyl twice daily, whereas 4090 patients were assigned to the placebo group. The primary efficacy end point was a composite of cardiovascular death and a series of cardiovascular events. After a median of 4.9 years of follow-up, 17.2% of the patients in the icosapent ethyl group experienced the primary endpoint, with respect to 22.0% of patients in the placebo group (hazard ratio, 0.75; 95%CI, 0.68 to 0.83; p<0.0001). The rate of ischemic events was significantly reduced in the icosapent ethyl group (4.3% v.s. 5.2%; hazard ratio, 0.80; 95%CI, 0.66 to 0.98; p=0.03). However, more patients in the icosapent ethyl group were hospitalized for atrial fibrillation or flutter (3.1% v.s. 2.1%; p=0.004). Patients in the icosapent ethyl group harboured a similar incidence of serious bleeding episodes compared to those in the placebo group.
Patients treated with statin and icosapent ethyl have a lower risk of cardiovascular events compared to those treated with statin and placebo.
This trial was supported by a pharmaceutic company.