Association between REDUCE-IT criteria, coronary artery disease severity and cardiovascular events: The Western Denmark Heart Registry

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • Martin Bødtker Mortensen
  • Omar Dzaye, Johns Hopkins University Bayview Proteomic Center, Department of Medicine, Johns Hopkins University School of Medicine
  • ,
  • Alexander C Razavi, Johns Hopkins University Bayview Proteomic Center, Department of Medicine, Johns Hopkins University School of Medicine
  • ,
  • Jesper Møller Jensen
  • Flemming Hald Steffensen, Department of Neurology, Lillebaelt Hospital, Vejle Hospital, Vejle, Denmark.
  • ,
  • Hans Erik Bøtker
  • Miguel Cainzos-Achirica, Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center; Cardiovascular Disease Section, Baylor College of Medicine; and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center; Houston, TX 77030, United States.
  • ,
  • Henrik Toft Sørensen
  • Michael Maeng
  • Michael J Blaha, Johns Hopkins University Bayview Proteomic Center, Department of Medicine, Johns Hopkins University School of Medicine
  • ,
  • Khurram Nasir, Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center; Cardiovascular Disease Section, Baylor College of Medicine; and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center; Houston, TX 77030, United States.
  • ,
  • Bjarne Linde Nørgaard

AIMS: The REDUCE-IT trial demonstrated that icosapent ethyl lowered the risk of atherosclerotic cardiovascular disease (ASCVD) among patients with elevated triglycerides. However, how to appropriately implement its use in clinical practice is not well-defined.We aimed to determine whether plaque burden as assessed by coronary artery calcium (CAC) could stratify ASCVD risk among patients eligible for icosapent ethyl.

METHODS AND RESULTS: Among 23,759 patients who underwent computed tomography angiography (CTA) in the Western Denmark Heart Registry, we identified eligibility for the REDUCE-IT trial. A total of 2146 participants (9%) met enrollment criteria for REDUCE-IT. During a median of 4.3 years of follow-up, 146 ASCVD events occurred. Overall, there was a stepwise increase in ASCVD event rates per 1,000 person-years with increasing CAC (CAC = 0: 10.5, CAC 1-299: 18.7, CAC ≥300: 49.8). REDUCE-IT eligible patients with CAC ≥300 had a multivariable-adjusted hazard ratio of 3.1 compared to CAC = 0 (95%CI: 1.9-4.9). CAC differentiated risk similarly in patients with and without obstructive CAD. Overall, the 5-year estimated number needed to treat to prevent one event with icosapent ethyl was 45 and ranged from 87 in those with CAC = 0 to 17 in those with CAC ≥300. Some patients with non-obstructive CAD had lower estimated NNT than patients with obstructive CAD when their plaque burden was higher.

CONCLUSION: Atherosclerotic plaque burden as assessed by CAC can identify REDUCE-IT eligible patients who are expected to derive most, and least, absolute benefit from treatment with icosapent ethyl regardless of obstructive versus nonobstructive CAD status.

Original languageEnglish
JournalEuropean Journal of Preventive Cardiology
ISSN2047-4873
DOIs
Publication statusE-pub ahead of print - 3 Jun 2022

Bibliographical note

© The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

See relations at Aarhus University Citationformats

ID: 272735165