Real-world study on the efficacy of icosapent ethyl in patients with very high-risk atherosclerotic cardiovascular disease

AIM  To assess the lipid-lowering efficacy and the impact on reducing cardiovascular risk prognosis of icosapent ethyl (IPE) in patients with very high-risk atherosclerotic cardiovascular disease (ASCVD) who were undergoing conventional treatment.

METHODS  From October 2023 to November 2023, very high-risk ASCVD patients who had undergone percutaneous coronary intervention (PCI) were recruited from the First Affiliated Hospital of the Air Force Medical University. These patients were divided into a treatment group (n=60) and a control group (n=60). Propensity score matching (PSM) was employed to adjust for confounding factors. The treatment group received icosapent ethyl in combination with conventional lipid-lowering therapy, while the control group only received conventional lipid-lowering treatment. In a real-world setting, biochemical indicators, including blood lipid levels, and cardiovascular adverse events of the patients were recorded.

RESULTS After 1∶1 propensity score matching, there were 120 patients in the two groups. The gender, age, geographical region, blood lipid baseline level, hypertension history, diabetes history, coronary artery disease history and other baseline characteristics of patients in IPE group and control group were balanced, and the difference between the groups was not statistically significant. Two groups of patients were followed up after one year, and the TG level in the IPE group was lower than that in the control group, while the HDL-C level was higher than that in the control group, with statistically significant differences (both P<0.05). The incidence of unstable angina events in the IPE group was lower than that in the control group, and the difference was statistically significant (P<0.05). The incidence of other cardiovascular events was lower than that of the control group, but there was no statistical difference; One year later, the levels of TC, TG, and LDL-C in the IPE group were lower than baseline levels (all P<0.01), while the level of HDL-C was higher than baseline levels (P<0.05).

CONCLUSION The combinationof icosapent ethyl with conventional LDL-lowering drugs provides more comprehensive blood lipids improvement when compared with LDL-lowering drugsalone. Icosapent ethyl treatment also reduces unstable angina incidence.