EPA’s pleiotropic mechanisms of action: a narrative review

Treatment with icosapent ethyl 4 g/day, a highly purified and stable ester of eicosapentaenoic acid (EPA), demonstrated significant reduction in atherosclerotic cardiovascular disease (ASCVD) events death REDUCE-IT. However, analyses REDUCE-IT meta-analyses have suggested that this clinical benefit is greater than can be achieved by triglyceride alone. EPA therefore may additional pleiotropic effects, including anti-inflammatory anti-aggregatory mechanisms. competes arachidonic for cyclooxygenase lipoxygenase, producing metabolites rather the more deleterious associated acid. Changing EPA:arachidonic ratio shift metabolic status from pro-inflammatory/pro-aggregatory to anti-inflammatory/anti-aggregatory. also has antioxidant effects increases synthesis nitric oxide. Incorporation into phospholipid bilayers influences membrane structure help prevent cardiac arrhythmias. Clinically, translate improved vascular health, regression plaque. Overall, range contribute ASCVD.