Cardiovascular Outcomes With Icosapent Ethyl by Baseline Low-Density Lipoprotein Cholesterol: A Secondary Analysis of the REDUCE-IT Randomized Trial.

• Tác giả: Rahul Aggarwal, Christie M Ballantyne, Deepak L Bhatt, Eliot A Brinton, Richard L Dunbar, Steven B Ketchum, Fabrice M A C Martens, R Preston Mason, Michael Miller, Ph Gabriel Steg, Michael Szarek, Jean-Claude Tardif
• Ngôn ngữ: eng
• Ký hiệu phân loại: 070.194 Radio
• Thông tin xuất bản: England : Journal of the American Heart Association , 2025
• Bộ sưu tập: NCBI
• ID: 213809

Tóm tắt

 BACKGROUND: The efficacy of icosapent ethyl among patients with very well-controlled baseline low-density lipoprotein cholesterol (LDL-C) is unknown. METHODS: In this post hoc analysis of the REDUCE-IT (Reduction of Cardiovascular Events With Icosapent Ethyl-Intervention Trial) randomized clinical trial, statin-treated patients with high cardiovascular risk, elevated triglycerides (135-499 mg/dL), and baseline LDL-C of 41 to 100 mg/dL were included. Patients were randomized to icosapent ethyl (2 g twice daily) or placebo and then post hoc stratified by baseline LDL-C (<
 55 mg/dL versus ≥55 mg/dL). The primary composite end point included cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or unstable angina. RESULTS: Among 8175 patients with baseline LDL-C data, 7117 (87.1%) had LDL-C ≥55 mg/dL and 1058 (12.9%) had LDL-C <
 55 mg/dL. In patients with LDL-C <
 55 mg/dL, the rate of the primary composite end point was lower in the icosapent ethyl group (16.2% versus 22.8%) than in the placebo group (hazard ratio [HR], 0.66 [95% CI, 0.50-0.87]
  absolute risk reduction, 6.6%
  CONCLUSIONS: Among statin-treated patients with elevated triglycerides and high cardiovascular risk, icosapent ethyl reduced the rate of cardiovascular end points irrespective of baseline LDL-C, including among eligible patients with optimal LDL-C control. REGISTRATION: URL: https://www.clinicaltrials.gov
  Unique identifier: NCT01492361.