Increased EPA Levels Linked to Lower Heart Failure Risk in REDUCE-IT Trial

Deepak Bhatt, MD, MPH

Adding to the impressive slate of data that has already come from the landmark trial, a new REDUCE-IT analysis suggests use of icosapent ethyl (Vascepa) could reduce risk of heart failure in patients with elevated triglycerides.

Presented at the American College of Cardiology 70th Annual Scientific Session (ACC.21), results of the post hoc analysis, which only included patients in the icosapent ethyl arm, indicate patients with the highest on-treatment levels of eicosapentaenoic acid (EPA) experienced a nearly 60% reduction in new heart failure and more than 50% reduction in new heart failure requiring hospitalization.

“The potential benefit of increased serum EPA levels in reducing the composite of cardiovascular death or new heart failure requiring hospitalization in at-risk patients is a novel finding for icosapent ethyl and requires further prospective validation. These results add to the growing body of knowledge regarding icosapent ethyl,” said Deepak Bhatt, MD, MPH, lead investigator of REDUCE-IT and Executive Director of Interventional Cardiovascular Programs at Brigham and Women’s Hospital, in a statement from Amarin.

With the results of the original REDUCE-IT trial demonstrating the reduction in cardiovascular risk associated with use of icosapent ethyl in patients with well-controlled LDL-C but elevated triglycerides, post hoc analyses of the trial have begun a regular fixture at major cardiology conferences in recent years. ACC.21 was no different with REDUCE-IT HF diving deeper into the impact of the purified EPA agent on risk of heart failure.

When assessing respecified tertiary endpoint of new heart failure and new heart failure requiring hospitalization, use of icosapent ethyl did not result in significant reductions for either. However, significant differences were observed when comparing patients according to on-treatment EPA tertiles.

Specifically, those in the middle (139 ug/mL) and upper (215 ug/mL) tertiles had lower risk for new heart failure ([HR, 0.55; 95% CI, 0.37-0.81, P=.003] and [HR, 0.41, 95% CI, 0.27-0.63, P <.0001], respectively) and new heart failure requiring hospitalization ([HR, 0.47; 95% CI, 0.30-0.74, p=0.0008] and [HR, 0.45; 95% CI, 0.29-0.70, P=.0005] when compared to their counterparts in the lowest on-treatment tertile of EPA (median 55 ug/mL).

For more on this study and how results inform clinical practice, Practical Cardiology reached out to Bhatt and that conversation is the subject of this ACC.21 House Call.

This study, “Reduction in Heart Failure with Icosapent Ethyl: Insights from REDUCE-IT HF,” was presented at ACC.21.