Journal of clinical lipidology · 2025
Estimate and prognosis of patients who are candidates for treatment with eicosapentaenoic acid after an acute coronary syndrome.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Cordero Alberto, Gonzalez-Juanatey José R, Fernandez Olmo Rosa, Fernandez-Freira Leticia, Manzano Sergio, Bonanad Clara, Alvarez-Alvarez Belén, Cortez Gustavo, Oterino Armando, Flores Blanco Pedro J, Castellano José M, Bhatt Deepak L
Аннотация
BACKGROUND: Treatment with icosapent ethyl (IPE) has been shown to reduce the incidence of major adverse cardiovascular events (MACE) in patients at high cardiovascular risk with mildly to moderately elevated triglyceride values (>135 mg/dL) and well-controlled (<100 mg/dL) low-density lipoprotein cholesterol (LDLc). The main objective of this study was to estimate the number of patients eligible for IPE after an acute coronary syndrome (ACS).
METHODS: Multicenter retrospective study based on ACS registries of patients from 8 hospitals in Spain. Patients with LdLc <100 mg/dL and triglyceride values >135 mg/dL were analyzed as candidates for IPE. The study endpoints were MACE (cardiovascular mortality, ACS, or readmission for heart failure or stroke) and all-cause mortality.
RESULTS: A total of 14,483 patients with ACS were included in the registry; the mean (SD) LDLc was 99.8 mg/dL (38.5), and the median value for triglycerides was 120.5 mg/dL (IQR: 90-197 mg/dL). Of this population, 3028 (20.9%) were classified as candidates for IPE. Median follow-up was 1223 days. Candidates for IPE had significantly higher rates of MACE (39.0% vs 33.6%) and mortality (18.4% vs 14.0%). Multivariate analysis identified an independently higher risk for MACE (hazard ratio [HR]: 1.14, 95% CI: 1.05-1.20) and all-cause mortality (HR: 1.10, 95% CI: 1.04-1.26) among candidates for IPE.
CONCLUSIONS: Approximately 20% of patients discharged after an ACS could be candidates for IPE, and this subset of patients are at higher risk of MACE or death.
METHODS: Multicenter retrospective study based on ACS registries of patients from 8 hospitals in Spain. Patients with LdLc <100 mg/dL and triglyceride values >135 mg/dL were analyzed as candidates for IPE. The study endpoints were MACE (cardiovascular mortality, ACS, or readmission for heart failure or stroke) and all-cause mortality.
RESULTS: A total of 14,483 patients with ACS were included in the registry; the mean (SD) LDLc was 99.8 mg/dL (38.5), and the median value for triglycerides was 120.5 mg/dL (IQR: 90-197 mg/dL). Of this population, 3028 (20.9%) were classified as candidates for IPE. Median follow-up was 1223 days. Candidates for IPE had significantly higher rates of MACE (39.0% vs 33.6%) and mortality (18.4% vs 14.0%). Multivariate analysis identified an independently higher risk for MACE (hazard ratio [HR]: 1.14, 95% CI: 1.05-1.20) and all-cause mortality (HR: 1.10, 95% CI: 1.04-1.26) among candidates for IPE.
CONCLUSIONS: Approximately 20% of patients discharged after an ACS could be candidates for IPE, and this subset of patients are at higher risk of MACE or death.