Mechanistic Insights from REDUCE-IT STRENGTHen the Case Against Triglyceride Lowering as a Strategy for Cardiovascular Disease Risk Reduction

Elevated triglyceride (TG) levels have been linked to residual atherosclerotic cardiovascular risk in patients with controlled low-density lipoprotein cholesterol. However, outcome trials testing TG-lowering agents failed demonstrate reduction statin-treated subjects. One such example is the recent STRENGTH trial, which tested mixed omega fatty acids (n3-FAs, 4 g/d) high-risk elevated TGs. Similar using fibrates and niacin, trial despite effective TG lowering. Results from these studies contributed skepticism about use of therapy for risk. new mechanistic insights are provided by REDUCE-IT that used icosapent ethyl (IPE), a purified formulation n3-FA eicosapentaenoic acid. In patients, IPE reduced composite events (25%, P < .001) manner not predicted Benefits appear broad pleiotropic actions associated on-treatment acid levels. These indicate although TGs potential biomarker risk, there no evidence lowering itself an strategy reducing