Opinion EDITORIAL What Matters Most: the Drug, the Dose, or the Placebo? Garima Sharma, MD; Seth S. Martin, MD, MHS; Roger S. Blumenthal, MD Hypertriglyceridemia is associated with an increased risk The risk reduction observed in REDUCE-IT prompted of atherosclerotic cardiovascular disease (ASCVD), indepen- further research into protective mechanistic changes of EPA on dent of low-density lipoprotein cholesterol (LDL-C) con- atherosclerotic coronary plaque. The Effect of Vascepa trol. Standard treatment strategies have included lifestyle on Improving Coronary Atherosclerosis in People With High Tri- modification, weight and dia- glycerides Taking Statin Therapy (EVAPORATE) trial, which in- betes management, and statin cluded 80 patients aged 30 through 85 years with known coro- Editor's Note therapy. Previous triglyceride- nary atherosclerosis and taking stable statin therapy, found that lowering trials with niacin, 4 g/d of IPE in addition to maximally tolerated statin therapy fibrates, and mixed omega-3 led to a relative reduction of 17% (−0.3 ± 1.5 mm in treatment Related article fatty acids have not demon- group vs 0.9 ± 1.7 mm in the statin-only group,P = .006) in low- 1,2 strated consistent risk reduction of ASCVD. However, strong attenuation plaque at 18 months in patients treated with IPE, evidence has recently
JAMA – American Medical Association
Published: Dec 8, 2020
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