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使用二十碳五烯酸乙酯对美国患者的人口统计学和临床特征进行横断面分析。

Cross-Sectional analysis of demographic and clinical characteristics of patients in the United States using icosapent ethyl.

作者信息

Toth Peter P, Nelson John R, Soran Handrean, Ganda Om P, Wong Nathan D, Hannachi Hakima, Abrahamson David, Hartman Josh, Luciano Sierra, Philip Sephy

机构信息

CGH Medical Center, Sterling, IL, United States.

Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States.

出版信息

Front Cardiovasc Med. 2025 Mar 14;12:1411233. doi: 10.3389/fcvm.2025.1411233. eCollection 2025.

Abstract

INTRODUCTION

Icosapent ethyl (IPE) is indicated for the treatment of severe hypertriglyceridemia (triglycerides ≥500 mg/dl) and for reducing the risk of cardiovascular (CV) events in statin-treated adults with moderately elevated triglycerides (150-499 mg/dl) and established CV disease [secondary prevention (SP)] or diabetes with CV risk factors [primary prevention (PP)]. We describe real-world characteristics of US patients taking IPE.

METHODS

Patients with ≥2 IPE prescriptions were identified in the TriNetX database. PP criteria were: ≥50 years with diabetes mellitus, ≥1 additional CV risk factor, and triglycerides 150-499 mg/dl. SP criteria were established CV disease and triglycerides 150-499 mg/dl.

RESULTS

Among patients with ≥2 IPE prescriptions and triglyceride data, 56.2% (18,897/33,645) met PP or SP criteria, 28.0% (9,431/33,645) had severe hypertriglyceridemia. In the PP and SP cohorts, mean (SD) ages were 62.7 (8.0) and 64.0 (10.7) years, respectively. In the SP cohort, coronary artery disease was the most common pre-existing CV disease (85.8%) and many had diabetes (63.1%). In the PP and SP cohorts, 81.7% and 90.4%, respectively, received statin treatment. Before IPE initiation, mean (SD; median) triglyceride levels were 305 (150; 253) and 279 (142; 230) mg/dl in the PP and SP cohorts, respectively, and mean/median LDL-C levels were <100 mg/dl in both.

DISCUSSION

Patients taking IPE had characteristics consistent with its indication, including well-controlled LDL-C levels with statin use. The higher triglyceride levels before IPE initiation suggest that IPE may be underutilized in patients at high risk for CV events; however, future studies are needed.

摘要

引言

二十碳五烯酸乙酯(IPE)适用于治疗严重高甘油三酯血症(甘油三酯≥500 mg/dl),并用于降低接受他汀类药物治疗、甘油三酯中度升高(150 - 499 mg/dl)且患有已确诊心血管疾病的成年人发生心血管(CV)事件的风险[二级预防(SP)],或用于降低患有心血管疾病风险因素的糖尿病成年人发生心血管事件的风险[一级预防(PP)]。我们描述了服用IPE的美国患者的真实世界特征。

方法

在TriNetX数据库中识别出有≥2份IPE处方的患者。一级预防标准为:年龄≥50岁、患有糖尿病、至少有1个其他心血管疾病风险因素且甘油三酯水平为150 - 499 mg/dl。二级预防标准为已确诊心血管疾病且甘油三酯水平为150 - 499 mg/dl。

结果

在有≥2份IPE处方且有甘油三酯数据的患者中,56.2%(18,897/33,645)符合一级预防或二级预防标准,28.0%(9,431/33,645)患有严重高甘油三酯血症。在一级预防和二级预防队列中,平均(标准差)年龄分别为62.7(8.0)岁和64.0(10.7)岁。在二级预防队列中,冠状动脉疾病是最常见的已患心血管疾病(85.8%),且许多患者患有糖尿病(63.1%)。在一级预防和二级预防队列中,分别有81.7%和90.4%的患者接受了他汀类药物治疗。在开始服用IPE之前,一级预防和二级预防队列中的平均(标准差;中位数)甘油三酯水平分别为305(150;253)mg/dl和279(142;230)mg/dl,且两个队列中的平均/中位数低密度脂蛋白胆固醇(LDL-C)水平均<100 mg/dl。

讨论

服用IPE的患者具有与其适应证相符的特征,包括使用他汀类药物时低密度脂蛋白胆固醇水平得到良好控制。开始服用IPE之前较高的甘油三酯水平表明,IPE在心血管事件高风险患者中可能未得到充分利用;然而,未来仍需开展研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5cd/11949980/ab646e68e32c/fcvm-12-1411233-g001.jpg

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