Physicians' Academy for Cardiovascular Education

Icosapent ethyl reduces first and total stroke in patients with or high risk of CVD

News - Mar. 17, 2021

Reduction in Ischemic Stroke With Icosapent Ethyl - Insights From REDUCE-IT

Presented at the International Stroke Conference 2021 by Deepak Bhatt (Boston, MA, USA)

Introduction and methods

In the REDUCE-IT trial, >8000 patients were enrolled of whom ~70% were secondary prevention patients and ~30% diabetes patients with at least one CV risk factor. Patients were randomized to icosapent ethyl 4 gr/day or placebo. Triglyceride levels had to be between 150-500 mg/dL and LDL-c between 40 and 100 mg/dL and patients were required be treated with a statin. Mean follow-up was ~5 years. Primary endpoint of the trial was time to first occurrence of composite of CV death, non-fatal MI, non-fatal stroke, coronary revascularization or unstable angina requiring hospitalization (5p MACE). Results of the main trial showed a 25% reduction of the primary outcome with icosapent ethyl compared to placebo. The key secondary composite endpoint of CV death, MI and stroke was also reduced by icosapent ethyl compared to placebo. Prespecified hierarchical testing showed that several endpoints were reduced, including first event of fatal or nonfatal stroke (a 28% reduction). Furthermore, analysis of total events (first and subsequent) showed a reduction of 31% in total events in the icosapent ethyl group compared to the placebo group.

In this analysis, additional prespecified and post hoc stroke endpoints in the REDUCE-IT trial were examined.

Main results

Conclusion

Icosapent ethyl 4 g/day reduces first and total strokes compared to placebo in patients with or at high risk of CVD, who are treated with statins. Moreover, icosapent ethyl reduced first and total ischemic strokes compared to placebo, without an increase in hemorrhagic stroke. The authors suggest that EPA-based therapy with icosapent ethyl represents a novel approach to reduce stroke.

- Our reporting is based on the information provided during ISC 2021 –

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