Targeting hypertriglyceridemia to mitigate cardiovascular risk: A review
A causal relationship between elevated triglycerides and cardiovascular disease is controversial, as trials of triglyceride-lowering treatments have not shown significant impact on cardiovascular outcomes. However, hypertriglyceridemia is associated with atherogenesis and risk for acute cardiovascul...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-09-01
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| Series: | American Journal of Preventive Cardiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666667720300866 |
| _version_ | 1818735136837992448 |
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| author | Peter P. Toth Prediman K. Shah Norman E. Lepor |
| author_facet | Peter P. Toth Prediman K. Shah Norman E. Lepor |
| author_sort | Peter P. Toth |
| collection | DOAJ |
| description | A causal relationship between elevated triglycerides and cardiovascular disease is controversial, as trials of triglyceride-lowering treatments have not shown significant impact on cardiovascular outcomes. However, hypertriglyceridemia is associated with atherogenesis and risk for acute cardiovascular events that persist despite optimal statin treatment. Although most trials of triglyceride-lowering treatments have been negative, in trials of niacin and fibrates, subgroup analyses in patients with higher baseline triglycerides and lower HDL-C levels suggest reduced incidence of cardiovascular endpoints. The REDUCE-IT trial demonstrated that addition of purified prescription eicosapentaenoic acid (icosapent ethyl) 4 g/day in high-risk patients with triglyceride levels 135–499 mg/dL and optimized statin treatment significantly reduced cardiovascular events versus placebo (hazard ratio 0.75; 95% confidence interval 0.68–0.83; P < 0.001). Benefit was seen regardless of baseline and on-treatment triglyceride levels, suggesting that other effects of eicosapentaenoic acid besides triglyceride reduction may have played a role. |
| first_indexed | 2024-12-18T00:16:28Z |
| format | Article |
| id | doaj.art-ab0a79a94a0441aeafd978cb9810cee3 |
| institution | Directory Open Access Journal |
| issn | 2666-6677 |
| language | English |
| last_indexed | 2024-12-18T00:16:28Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Preventive Cardiology |
| spelling | doaj.art-ab0a79a94a0441aeafd978cb9810cee32022-12-21T21:27:31ZengElsevierAmerican Journal of Preventive Cardiology2666-66772020-09-013100086Targeting hypertriglyceridemia to mitigate cardiovascular risk: A reviewPeter P. Toth0Prediman K. Shah1Norman E. Lepor2CGH Medical Center, Sterling, IL, USA; Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Corresponding author. CGH Medical Center, 101 East Miller Road, Sterling, IL, 61081, USA.Smidt Heart Institute at Cedars-Sinai Medical Center, Los Angeles, CA, USASmidt Heart Institute at Cedars-Sinai Medical Center, Los Angeles, CA, USAA causal relationship between elevated triglycerides and cardiovascular disease is controversial, as trials of triglyceride-lowering treatments have not shown significant impact on cardiovascular outcomes. However, hypertriglyceridemia is associated with atherogenesis and risk for acute cardiovascular events that persist despite optimal statin treatment. Although most trials of triglyceride-lowering treatments have been negative, in trials of niacin and fibrates, subgroup analyses in patients with higher baseline triglycerides and lower HDL-C levels suggest reduced incidence of cardiovascular endpoints. The REDUCE-IT trial demonstrated that addition of purified prescription eicosapentaenoic acid (icosapent ethyl) 4 g/day in high-risk patients with triglyceride levels 135–499 mg/dL and optimized statin treatment significantly reduced cardiovascular events versus placebo (hazard ratio 0.75; 95% confidence interval 0.68–0.83; P < 0.001). Benefit was seen regardless of baseline and on-treatment triglyceride levels, suggesting that other effects of eicosapentaenoic acid besides triglyceride reduction may have played a role.http://www.sciencedirect.com/science/article/pii/S2666667720300866TriglyceridesREDUCE-ITIcosapent ethylEicosapentaenoic acid |
| spellingShingle | Peter P. Toth Prediman K. Shah Norman E. Lepor Targeting hypertriglyceridemia to mitigate cardiovascular risk: A review American Journal of Preventive Cardiology Triglycerides REDUCE-IT Icosapent ethyl Eicosapentaenoic acid |
| title | Targeting hypertriglyceridemia to mitigate cardiovascular risk: A review |
| title_full | Targeting hypertriglyceridemia to mitigate cardiovascular risk: A review |
| title_fullStr | Targeting hypertriglyceridemia to mitigate cardiovascular risk: A review |
| title_full_unstemmed | Targeting hypertriglyceridemia to mitigate cardiovascular risk: A review |
| title_short | Targeting hypertriglyceridemia to mitigate cardiovascular risk: A review |
| title_sort | targeting hypertriglyceridemia to mitigate cardiovascular risk a review |
| topic | Triglycerides REDUCE-IT Icosapent ethyl Eicosapentaenoic acid |
| url | http://www.sciencedirect.com/science/article/pii/S2666667720300866 |
| work_keys_str_mv | AT peterptoth targetinghypertriglyceridemiatomitigatecardiovascularriskareview AT predimankshah targetinghypertriglyceridemiatomitigatecardiovascularriskareview AT normanelepor targetinghypertriglyceridemiatomitigatecardiovascularriskareview |