Bazarbashi Najdat, Miller Michael
Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Expert Rev Cardiovasc Ther. 2020 Apr;18(4):175-180. doi: 10.1080/14779072.2020.1749596. Epub 2020 Apr 6.
Icosapent ethyl (IPE) is a highly purified (>96%) form of eicosapentanoic acid, a marine-derived omega-3 fatty acid known to reduce serum triglyceride (TG) levels. In the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT), the addition of 4 g IPE daily resulted in a 25% reduction in cardiovascular events beyond statins and other standard of care therapies. IPE is now the only therapy currently approved by the Food and Drug Administration to treat patients with elevated TGs (150-499 mg/dL) with cardiovascular disease (CVD) or Type 2 diabetes mellitus and two or more CVD risk factors.: IPE is a highly purified form of eicosapentanoic acid for patients with elevated TGs as monotherapy or combined with statins and/or other lipid lowering therapies.The REDUCE-IT Study demonstrated a 25% reduction in the primary outcome measure and 30% reduction in total CVD events in high-risk patients with elevated TGs (135-499 mg/dL) assigned to IPE (4 g daily).Side effects included a statistically significant increased risk of atrial fibrillation and bleeding, although the risk of stroke was reduced and there were no cases of fatal bleeding.The FDA recently approved IPE for treatment of patients with TG levels of 150-499 mg/dL and preexisting CVD or Type 2 diabetes mellitus with two or more risk factors.:IPE has proven to be superior to other forms of omega 3 fatty acid in reducing CVD risk in patients with elevated TG. This could be attributed to multiple factors including the use of highly purified eicosapentaenoic acid ethyl esters without docosahexaenoic acid (DHA), thus preventing the increase in low-density lipoprotein cholesterol associated with DHA especially at high TG levels, reduction in atherogenic TG-rich particles, antioxidant and anti-inflammatory properties, improvement in endothelial function, and stabilization of atherosclerotic plaque.
二十碳五烯酸乙酯（IPE）是一种高度纯化（>96%）的二十碳五烯酸形式，二十碳五烯酸是一种源自海洋的ω-3脂肪酸，已知可降低血清甘油三酯（TG）水平。在二十碳五烯酸乙酯干预降低心血管事件试验（REDUCE-IT）中，每日添加4克IPE导致心血管事件比他汀类药物和其他标准治疗疗法减少25%。IPE现在是美国食品药品监督管理局目前批准的唯一一种用于治疗甘油三酯水平升高（150 - 499毫克/分升）且患有心血管疾病（CVD）或2型糖尿病以及两个或更多心血管疾病风险因素的患者的疗法。：IPE是一种高度纯化的二十碳五烯酸形式，可作为单一疗法或与他汀类药物和/或其他降脂疗法联合用于甘油三酯水平升高的患者。REDUCE-IT研究表明，在分配接受IPE（每日4克）治疗的甘油三酯水平升高（135 - 499毫克/分升）的高危患者中，主要结局指标降低了25%，总心血管疾病事件降低了30%。副作用包括房颤和出血风险在统计学上显著增加，尽管中风风险降低且没有致命出血病例。美国食品药品监督管理局最近批准IPE用于治疗甘油三酯水平为150 - 499毫克/分升且已有心血管疾病或2型糖尿病以及两个或更多风险因素的患者。：在降低甘油三酯水平升高患者的心血管疾病风险方面，IPE已被证明优于其他形式的ω-3脂肪酸。这可能归因于多种因素，包括使用不含二十二碳六烯酸（DHA）的高度纯化的二十碳五烯酸乙酯，从而防止与DHA相关的低密度脂蛋白胆固醇升高，尤其是在高甘油三酯水平时，减少富含致动脉粥样硬化甘油三酯的颗粒，具有抗氧化和抗炎特性，改善内皮功能以及稳定动脉粥样硬化斑块。
