Physicians' Academy for Cardiovascular Education

Icosapent ethyl reduces MI overall and MI subtypes

News - Sep. 7, 2022

REDUCE-IT: Significant Reduction in ST-Elevation MI With Icosapent Ethyl

Presented at the ESC congress 2022 by: Prof. Deepak Bhatt, MD- Boston, MA, USA

Introduction and methods

In the REDUCE-IT trial, 70% of the enrolled patients had CVD and 30% were at high risk for CVD in a primary prevention setting (diabetes plus one additional CV risk factor). All patients had mildly elevated triglycerides (135-500 mg/dL) and well-controlled LDL-c (40-100 mg/dL [1-2.6 mmol/L]) on statin therapy. ~8000 Patients were randomized to icosapent ethyl (2 grams twice a day) or to a matching mineral oil placebo (colorless and odorless). Mean follow-up was 4.9 years.

The primary composite endpoint -time to first occurrence of CV death, non-fatal MI, non-fatal stroke, coronary revascularization or unstable angina requiring hospitalization (5-point MACE) – was reduced by 25% in the icosapent ethyl group compared with the placebo group (HR 0.75, 95%CI:0.68-0.83). A similar risk reduction was seen with icosapent ethyl for the key secondary composite endpoint of CV death, MI or stroke.

Main results

Conclusion

This analysis of REDUCE-IT showed that treatment with icosapent ethyl 4 g/day significantly reduced MI overall and MI subtypes, including STEMI, NSTEMI, MI leading to cardiac arrest and resuscitated MI. There was no significant increase in serious bleeding. Furthermore, icosapent ethyl reduced all sizes of MI, also large MI types.

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