Lan Nick S R, Ali Umar S, Larbalestier Robert, Dwivedi Girish, Bell Damon A
Department of Cardiology, Fiona Stanley Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia.
Medical School, The University of Western Australia, Perth, Australia; Department of Cardiothoracic Surgery, Fiona Stanley Hospital, Perth, Australia.
Cardiovasc Revasc Med. 2022 Aug;41:170-172. doi: 10.1016/j.carrev.2021.12.025. Epub 2021 Dec 30.
Icosapent ethyl reduces cardiovascular events in high-risk patients with hypertriglyceridaemia on statin therapy. However, it is not widely available and the potential application following coronary artery bypass graft (CABG) surgery is not well-established. We aimed to determine the real-world percentage of CABG surgery patients who may be eligible for the therapy.
A retrospective analysis was performed between February 2015 and August 2020 in an Australian hospital. Patients were included if a lipid profile was performed at least three weeks following CABG surgery. Data was extracted from electronic medical records. Eligibility for icosapent ethyl was defined according to inclusion criteria from the REDUCE-IT trial.
Of 484 patients with follow-up lipid profiles, 21 (4.3%) were not eligible for icosapent ethyl based on age and 39 (8.1%) were not prescribed statin therapy or were prescribed a fibrate. After applying triglyceride and low-density lipoprotein cholesterol level criteria, 124 (25.6%) patients were potentially eligible for icosapent ethyl therapy. Of those eligible, high-intensity statin therapy were prescribed in 108 (87.1%).
A substantial percentage of CABG surgery patients may be eligible for icosapent ethyl and could potentially benefit from its cardiovascular protection. Further research should evaluate the additional cardiovascular benefits of icosapent ethyl in this very high-risk group of patients who are already treated with high-intensity statins.
二十碳五烯酸乙酯可降低接受他汀类药物治疗的高危高甘油三酯血症患者的心血管事件发生率。然而，该药物尚未广泛应用，其在冠状动脉旁路移植术（CABG）后的潜在应用也尚未明确。我们旨在确定可能符合该治疗条件的CABG手术患者的实际比例。
于2015年2月至2020年8月在一家澳大利亚医院进行回顾性分析。若患者在CABG手术后至少三周进行了血脂检查，则纳入研究。数据从电子病历中提取。二十碳五烯酸乙酯的适用标准根据REDUCE-IT试验的纳入标准确定。
在484例有随访血脂检查结果的患者中，21例（4.3%）因年龄不符合二十碳五烯酸乙酯的适用标准，39例（8.1%）未接受他汀类药物治疗或接受了贝特类药物治疗。在应用甘油三酯和低密度脂蛋白胆固醇水平标准后，124例（25.6%）患者可能符合二十碳五烯酸乙酯治疗条件。在这些符合条件的患者中，108例（87.1%）接受了高强度他汀类药物治疗。
相当比例的CABG手术患者可能符合二十碳五烯酸乙酯的适用条件，并可能从其心血管保护作用中获益。进一步的研究应评估二十碳五烯酸乙酯在这群已经接受高强度他汀类药物治疗的极高危患者中的额外心血管益处。
