Department of Pharmacology and Toxicology, University of Toronto.
Division of Cardiac Surgery, St. Michael's Hospital.
Curr Opin Cardiol. 2021 Mar 1;36(2):172-178. doi: 10.1097/HCO.0000000000000800.
Following coronary artery bypass grafting (CABG), there remains persistent risk of ischemic events despite secondary prevention strategies, including low-density lipoprotein cholesterol lowering. Although REDUCE-IT recently demonstrated the benefits of icosapent ethyl (IPE) on reducing ischemic events in a broad population of primary and secondary prevention patients, its generalizability to a contemporary CABG population is not known. This article aims to ascertain the proportion of patients with a history of CABG that would be eligible for IPE treatment.
A review of recent literature highlights the presence of residual ischemic following CABG. Using the Québec Heart Database, a repository of contemporary Canadian cardiac patient information, was searched between 1 January 2006 and 31 December 2016, to ascertain generalizability of IPE.
In a large (N = 12 641), contemporary, Canadian cohort of patients with a history of CABG and currently on statin therapy, 21.9, 33.6 and 26.4% would be eligible for IPE, according to REDUCE-IT, Health Canada, and Food and Drug Administration criteria, respectively. These analyses would support IPE as an adjunct to secondary prevention therapies post-CABG.
尽管采用了包括降低低密度脂蛋白胆固醇在内的二级预防策略，但在冠状动脉旁路移植术后（CABG）仍然存在持续的缺血事件风险。尽管 REDUCE-IT 最近证明了依泽替米贝（IPE）在降低广泛的一级和二级预防患者缺血事件方面的益处，但它在当代 CABG 人群中的普遍性尚不清楚。本文旨在确定有 CABG 病史的患者中有多少比例适合接受 IPE 治疗。
对最近文献的回顾强调了 CABG 后仍存在残余缺血。使用魁北克心脏数据库，这是一个加拿大当代心脏患者信息库，在 2006 年 1 月 1 日至 2016 年 12 月 31 日期间进行了搜索，以确定 IPE 的普遍性。
在一个大型（N=12641）、当代、加拿大 CABG 病史且目前正在接受他汀类药物治疗的患者队列中，根据 REDUCE-IT、加拿大卫生部和美国食品和药物管理局的标准，分别有 21.9%、33.6%和 26.4%的患者适合接受 IPE。这些分析将支持 IPE 作为 CABG 后二级预防治疗的辅助手段。
