Generalizability of the REDUCE-IT Trial in Patients With Stable Coronary Artery Disease

Epidemiological studies suggest that both moderate and severe hypertriglyceridemia are associated with increased long-term cardiovascular risk and mortality. Interestingly, the REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention) randomized trial recently enrolled 8,179 statin-treated patients with elevated triglyceride levels ($135 and <500 mg/dl) and either established cardiovascular disease or diabetes plus at least 1 risk factor, and demonstrated that a high dose (4 g/day) of icosapent ethyl reduced the risk of ischemic events, including cardiovascular death (1). Indeed, the secondary prevention cohort represented 70.7% of the total cohort, which experienced a lower rate of the key secondary efficacy composite endpoint of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke as compared with the placebo group (12.5% vs. 16.9%; hazard ratio: 0.72; 95% confidence interval: 0.63 to 0.82).