Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, United States (Drs Gaba, Bhatt, and Mason).
Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, United States (Drs Gaba, Bhatt, and Mason).
J Clin Lipidol. 2022 Jul-Aug;16(4):389-402. doi: 10.1016/j.jacl.2022.05.067. Epub 2022 Jun 4.
REDUCE-IT was a multinational, double-blind trial that randomized 8179 statin-treated patients with controlled low-density lipoprotein cholesterol and moderately elevated triglycerides to icosapent ethyl (IPE) or placebo. IPE was associated with a substantial reduction in the primary composite endpoint of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or unstable angina requiring hospitalization. Since the original publication of the trial, there have been a myriad of additional analyses confirming the benefit of IPE in various patient groups. Our objectives in this review are to summarize the key findings of the REDUCE-IT trial and its subsequent analyses as well as to call for the reevaluation and expansion of current guidelines to incorporate IPE as a therapy for patients at elevated cardiovascular risk with mild or moderate hypertriglyceridemia.
REDUCE-IT 是一项多中心、双盲临床试验,共纳入 8179 例他汀类药物治疗后 LDL-C 控制良好但伴有中等程度升高的 TG 的患者,随机分为依折麦布组和安慰剂组。依折麦布可显著降低主要复合终点(心血管死亡、非致死性心肌梗死、非致死性卒中等)的发生风险。自该临床试验发表以来,又有大量的后续分析进一步证实了依折麦布在各类患者人群中的获益。本综述旨在总结 REDUCE-IT 试验及其后续分析的关键发现,并呼吁重新评估和扩展现行指南,将依折麦布纳入轻中度高甘油三酯血症的心血管高危患者的治疗方案中。