Effects of icosapent ethyl according to baseline residual risk in patients with atherosclerotic cardiovascular disease: results from REDUCE-IT
Authors' conclusion
Among patients with ASCVD and elevated triglyceride levels, icosapent ethyl significantly reduces the risk of MACE irrespective of baseline CVD risk, though absolute benefits are largest for patients at the highest risk.
Study context
- Population
- REDUCE-IT participants with atherosclerotic cardiovascular disease (ASCVD) and elevated TG; baseline 5-year major adverse cardiovascular events (MACE) risk estimated by SMART2 risk scoreREDUCE-IT patients with ASCVD
- Participants
- 5,785 participants
- Comparison
- Icosapent ethyl vs placebo
- Primary endpoint
- 3-point MACE:
- Non-fatal MI
- Non-fatal stroke
- CV death
- Follow-up
- Median 4.8 years (IQR 3.2-5.3)
Methodological detailssubgroup analysis by baseline risk quartile
- Subgroup analysis by baseline risk quartile
Primary result
As reported in the abstract
3-point MACE by quartile of baseline SMART2 risk · median follow-up 4.8 years
Icosapent ethyl
361
events
Placebo
489
events
Icosapent ethyl vs PlaceboEstimate (95% CI)
Lowest risk quartile
HR 0.62(0.43–0.88)
Second risk quartile
HR 0.66(0.48–0.92)
Third risk quartile
HR 0.69(0.53–0.90)
Highest risk quartile
HR 0.78(0.63–0.96)
Lowest risk quartile
ARR 3.9%(1.0–6.8%)
Second risk quartile
ARR 4.3%(1.2–7.3%)
Third risk quartile
ARR 5.1%(1.4–8.7%)
Highest risk quartile
ARR 5.6%(1.3–10.0%)
Further findings
| Outcome | Estimate | |
|---|---|---|
| 3-point MACE, overall ASCVD population · median follow-up 4.8 yearsIcosapent ethyl vs Placebo | HR 0.72 (95% CI 0.63–0.82) | |
| 3-point MACE, overall ASCVD population · median follow-up 4.8 yearsIcosapent ethyl vs Placebo | ARR 4.4% (95% CI 2.6–6.2%) | |
| 0.10.31310Ratio (log scale) |
| Outcome | Estimate |
|---|---|
| 3-point MACE, overall ASCVD population · median follow-up 4.8 yearsIcosapent ethyl vs Placebo | NNT 23 (95% CI 16–38) |
| 3-point MACE, overall ASCVD population · median follow-up 4.8 yearsIcosapent ethyl vs Placebo | 5-year CIR 5.7% (95% CI 3.5–7.9%) |
5-point MACE (adds coronary revascularization and unstable angina)
- Consistent results
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Effects of icosapent ethyl according to baseline residual risk in patients with atherosclerotic cardiovascular disease: results from REDUCE-IT. Eur Heart J Cardiovasc Pharmacother. Published 27 April 2024. doi:10.
Summarised from the published abstract; every number is checked against it