Compared with placebo, icosapent ethyl (IPE) significantly reduced multiple plaque components, including vulnerable (low attenuation) plaque in patients with elevated triglycerides and on statin therapy, according to findings from the EVAPORATE trial presented during ESC Congress 2020 and simultaneously published in European Heart Journal.

The study, led by Matthew J. Budoff, MD, FACC, enrolled 80 patients aged 30-85 years with known coronary atherosclerosis and on stable statin therapy. The primary endpoint was change in low-attenuation plaque volume at 18 months. All patients were randomized to receive either IPE (4 g/day) or placebo and had a multidetector computed tomography (MDCT) scan at nine months, followed by a final scan at 18 months.

Despite the small sample size, Budoff and colleagues noted demonstrated benefits of IPE on outcomes and plaque reduction as early as nine months, with increasing significance by 18 months. "To the best of our knowledge, this is the first elegant marriage of clinical trial results (REDUCE-IT) and imaging (EVAPORATE)," Budoff said. "These data highlight the early and substantial impact of IPE on the atherothrombotic burden in this at-risk population."

"Evaporate provides further confidence in the clinical findings from the Reduce-It clinical trial," said ACC.org Editor in Chief Kim A. Eagle, MD, MACC. "Having mechanistic data like this to corroborate what we saw with the reduction of cardiovascular events in humans in the large randomized trial firmly establishes this therapeutic strategy as a cornerstone in preventive therapies."

Clinical Topics: Acute Coronary Syndromes, Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention

Keywords: ESC Congress, ESC20, Dyslipidemias, Primary Prevention, Acute Coronary Syndrome

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