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    Treatment With Icosapent Ethyl to Reduce Ischemic Events in Patients With Prior Percutaneous Coronary Intervention: Insights From REDUCE-IT PCI.

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    Author
    Peterson, Benjamin E
    Bhatt, Deepak L
    Steg, Ph Gabriel
    Miller, Michael
    Brinton, Eliot A
    Jacobson, Terry A
    Ketchum, Steven B
    Juliano, Rebecca A
    Jiao, Lixia
    Doyle, Ralph T
    Granowitz, Craig
    Gibson, C Michael
    Pinto, Duane
    Giugliano, Robert P
    Budoff, Matthew J
    Tardif, Jean-Claude
    Verma, Subodh
    Ballantyne, Christie M
    Show allShow less

    Date
    2022-03-09
    Journal
    Journal of the American Heart Association
    Publisher
    Wiley-Blackwell
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1161/JAHA.121.022937
    Abstract
    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.
    Keyword
    eicosapentaenoic acid
    icosapent ethyl
    prevention
    revascularization
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/18289
    ae974a485f413a2113503eed53cd6c53
    10.1161/JAHA.121.022937
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