{"id":"70a00144cdac","type":"article","url":"https://hartvaat.nl/2019/01/03/icosapent-ethyl-en-cardiovasculaire-uitkomsten-bij-hypertriglyceridemie-nejm-red/","title":"Icosapent-ethyl en cardiovasculaire uitkomsten bij hypertriglyceridemie: NEJM REDUCE-IT","title_en":"Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia.","category":"cholesterol","category_label":"Cholesterol","professions":["apotheker","cardioloog","huisarts","internist"],"tags":["ezetimibe","farmaco-economie","lipidenverlaging","niet-statine-therapie"],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa1812792","source_url":"https://doi.org/10.1056/NEJMoa1812792","authors":["Deepak L Bhatt","P Gabriel Steg","Michael Miller","Eliot A Brinton","Terry A Jacobson","Steven B Ketchum","Ralph T Doyle","Rebecca A Juliano","Lixia Jiao","Craig Granowitz","Jean-Claude Tardif","Christie M Ballantyne"],"significance":10,"published":"2019-01-03","source_date":"2019-01-03","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/omega3-vetzuren-cardiologie/","https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/"],"congress":"","summary_en":"The REDUCE-IT trial demonstrated that icosapent ethyl (purified EPA) reduced cardiovascular events by 25% in statin-treated patients with elevated triglycerides and established cardiovascular disease or diabetes. This landmark result established a role for triglyceride-lowering therapy in residual cardiovascular risk reduction.","created":"2026-07-03T10:27:42Z","updated":"2026-07-03T13:26:55Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Landmark NEJM REDUCE-IT-trial die aantoonde dat icosapent-ethyl (gezuiverd EPA) cardiovasculaire events significant vermindert bij statinebehandelde patiënten met hypertriglyceridemie. Paradigmashift voor triglyceridebehandeling.","abstract_original":"BACKGROUND: Patients with elevated triglyceride levels are at increased risk for ischemic events. Icosapent ethyl, a highly purified eicosapentaenoic acid ethyl ester, lowers triglyceride levels, but data are needed to determine its effects on ischemic events. METHODS: We performed a multicenter, randomized, double-blind, placebo-controlled trial involving patients with established cardiovascular disease or with diabetes and other risk factors, who had been receiving statin therapy and who had a fasting triglyceride level of 135 to 499 mg per deciliter (1.52 to 5.63 mmol per liter) and a low-density lipoprotein cholesterol level of 41 to 100 mg per deciliter (1.06 to 2.59 mmol per liter). The patients were randomly assigned to receive 2 g of icosapent ethyl twice daily (total daily dose, 4 g) or placebo. The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or unstable angina. The key secondary end point was a composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. RESULTS: A total of 8179 patients were enrolled (70.7% for secondary prevention of cardiovascular events) and were followed for a median of 4.9 years. A primary end-point event occurred in 17.2% of the patients in the icosapent ethyl group, as compared with 22.0% of the patients in the placebo group (hazard ratio, 0.75; 95% confidence interval [CI], 0.68 to 0.83; P<0.001); the corresponding rates of the key secondary end point were 11.2% and 14.8% (hazard ratio, 0.74; 95% CI, 0.65 to 0.83; P<0.001). The rates of additional ischemic end points, as assessed according to a prespecified hierarchical schema, were significantly lower in the icosapent ethyl group than in the placebo group, including the rate of cardiovascular death (4.3% vs. 5.2%; hazard ratio, 0.80; 95% CI, 0.66 to 0.98; P=0.03). A larger percentage of patients in the icosapent ethyl group than in the placebo group were hospitalized for atrial fibrillation or flutter (3.1% vs. 2.1%, P=0.004). Serious bleeding events occurred in 2.7% of the patients in the icosapent ethyl group and in 2.1% in the placebo group (P=0.06). CONCLUSIONS: Among patients with elevated triglyceride levels despite the use of statins, the risk of ischemic events, including cardiovascular death, was significantly lower among those who received 2 g of icosapent ethyl twice daily than among those who received placebo. (Funded by Amarin Pharma; REDUCE-IT ClinicalTrials.gov number, NCT01492361 .)."}