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10-1161-JAHA-121-022937 |
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|a 20479980 (ISSN)
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|a Treatment With Icosapent Ethyl to Reduce Ischemic Events in Patients With Prior Percutaneous Coronary Intervention: Insights From REDUCE-IT PCI
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|b American Heart Association Inc.
|c 2022
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|z View Fulltext in Publisher
|u https://doi.org/10.1161/JAHA.121.022937
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|a BACKGROUND: Patients who undergo percutaneous coronary intervention (PCI) are at increased risk for recurrent cardiovascular events despite aggressive medical therapy. METHODS AND RESULTS: This post hoc analysis focused on the subset of patients with prior PCI enrolled in REDUCE-IT (Reduction of Cardiovascular Events With Icosapent Ethyl–Intervention Trial), a multicenter, randomized, double-blind, placebo-controlled trial of icosapent ethyl versus placebo. Icosapent ethyl was added to statins in patients with low-density lipoprotein cholesterol <100 mg/dL and fasting triglycerides 135–499 mg/dL. The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or unstable angina requiring hospitalization. There were 8179 patients randomized in REDUCE-IT followed for a median of 4.9 years, and 3408 (41.7%) of them had a prior PCI with a median follow-up of 4.8 years. These patients were randomized a median of 2.9 years (11 days to 30.7 years) after PCI. Among patients treated with icosapent ethyl versus placebo, there was a 34% reduction in the primary composite end point (hazard ratio [HR], 0.66; 95% CI, 0.58–0.76; P<0.001; number needed to treat4.8 years=12) and a 34% reduction in the key secondary composite end point of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke (HR, 0.66; 95% CI, 0.56–0.79; P<0.001; NNT4.8 years=19) versus placebo. Similarly, large reductions occurred in total coronary revascularizations and revascularization subtypes. There was also a 39% reduction in total events (rate ratio, 0.61; 95% CI, 0.52–0.72; P<0.001). CONCLUSIONS: Among patients treated with statins with elevated triglycerides and a history of prior PCI, icosapent ethyl substantially reduced the risk of recurrent events during an average of ~5 years of follow-up with a number needed to treat of only 12. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01492361. © 2022 The Authors.
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|a eicosapentaenoic acid
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|a icosapent ethyl
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|a prevention
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|a revascularization
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|a Ballantyne, C.M.
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|a Bhatt, D.L.
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|a Brinton, E.A.
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|a Budoff, M.J.
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|a Doyle, R.T., Jr.
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|a Gibson, C.M.
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|a Giugliano, R.P.
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|a Granowitz, C.
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|a Jacobson, T.A.
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|a Jiao, L.
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|a Juliano, R.A.
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|a Ketchum, S.B.
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|a Miller, M.
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|a Peterson, B.E.
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|a Pinto, D.
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|a Steg, P.G.
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|a Tardif, J.-C.
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|a Verma, S.
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|t Journal of the American Heart Association
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