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    Effects of Icosapent Ethyl (Eicosapentaenoic Acid Ethyl Ester) on Atherogenic Lipid/Lipoprotein, Apolipoprotein, and Inflammatory Parameters in Patients With Elevated High-Sensitivity C-Reactive Protein (from the ANCHOR Study)

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    Author
    Miller, M.
    Ballantyne, C.M.
    Bays, H.E.
    Date
    2019
    Journal
    American Journal of Cardiology
    Publisher
    Elsevier Inc.
    Type
    Article
    
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    https://doi.org/10.1016/j.amjcard.2019.05.057
    Abstract
    cosapent ethyl is pure prescription eicosapentaenoic acid approved at 4 g/day as an adjunct to diet to reduce triglycerides (TG) in adults with TG ≥500 mg/dl. Elevated high-sensitivity C-reactive protein (hsCRP) is associated with increased cardiovascular risk. The 12-week ANCHOR study randomized 702 statin-treated patients at increased cardiovascular risk with TG 200 to 499 mg/dl despite low-density lipoprotein cholesterol (LDL-C) control (40 to 99 mg/dl). This post hoc analysis assessed 246 ANCHOR patients with baseline hsCRP ≥ 2.0 mg/L randomized to icosapent ethyl 4 g/day (n = 126; approved dose) or placebo (n = 120). Without increasing LDL-C, icosapent ethyl significantly reduced median TG (−20%; p < 0.0001), non–high-density lipoprotein cholesterol (−12.3%; p < 0.0001), total cholesterol (−11.1%; p < 0.0001), high-density lipoprotein cholesterol (−5.2%; p = 0.0042), very LDL-C (−21.0%; p < 0.0001), very low-density lipoprotein TG (−22.9%; p < 0.0001), remnant lipoprotein cholesterol (−23.0%; p = 0.0125), apolipoprotein B (−7.4%; p = 0.0021), apolipoprotein C-III (−16%; p < 0.0001), oxidized LDL (−13.7%; p = 0.0020), lipoprotein-associated phospholipase A2 (−19.6%; p < 0.0001), and hsCRP (−17.9%; p = 0.0213) versus placebo, while interleukin-6 and intercellular adhesion molecule-1 were not significantly changed. Eicosapentaenoic acid increased with icosapent ethyl 4 g/day +637% in plasma and +632% in red blood cells versus placebo (both p < 0.0001). Icosapent ethyl exhibited a safety profile similar to placebo. In conclusion, in statin-treated patients with hsCRP ≥ 2.0 mg/L and TG 200 to 499 mg/dl at baseline, icosapent ethyl 4 g/day significantly and safely reduced TG and other atherogenic and inflammatory parameters without increasing LDL-C versus placebo. Copyright 2019 The Authors
    Keyword
    cardiovascular risk
    high-sensitivity C-reactive protein
    hsCRP
    Eicosapentaenoic Acid
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85068164451&doi=10.1016%2fj.amjcard.2019.05.057&partnerID=40&md5=7b6b80f87c20c7ff6be30aca6aa64137; http://hdl.handle.net/10713/10617
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.amjcard.2019.05.057
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