Cardiovascular outcomes and prevention using icosapent ethyl: an updated meta-analysis

SESSION TITLE: Cardiovascular Disease Posters 3 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: We conducted a meta-analysis to review preventive benefits and cardiovascular outcomes of icosapent ethyl (IPE) use in prevention of coronary artery disease. METHODS: Online databases including EMBASE, and CINAHL were queried from inception to November 2022. Odds ratios (OR) were calculated using a random-effect model. Primary outcomes were the primary cardiovascular composite outcome, cardiovascular mortality, and all-cause mortality. The secondary outcomes included the recurrence of fatal/nonfatal stroke, fatal/nonfatal myocardial infarction, and revascularization. RESULTS: A total of 3 studies with 29,330 patients (IPE n=14,664; control n=14,666) were included in our analysis. IPE was associated with a lower incidence of primary cardiovascular composite outcome (OR 0.78, 95% CI 0.72-0.85, I2=0.00%, p<0.01) as compared to placebo. Cardiovascular mortality (OR 0.83, 95% CI 0.69-1.01, I2=0.00%, p=0.06) and all-cause mortality (OR 0.98, 95% CI 0.80-1.19, I2=62.39%, p=0.81) were similar among IPE and control arm. In addition, the odds of fatal/non-fatal MI (OR 0.72, 95% CI 0.62-0.83, I2=0.00%, p<0.01) and odds of revascularization need (OR 0.76, 95% CI 0.60-0.96, I2=69.64%, p=0.02) were lower in IPE compared to control, while there was no difference in odds of fatal/non-fatal stroke (OR 0.87, 95% CI 0.63-1.21, I2=72.97%, p=0.42). CONCLUSIONS: Our meta-analysis suggests that IPE use, in addition to standard therapy, is beneficial in the prevention of major adverse cardiovascular events, but not in reducing the risk of cardiovascular mortality and all-cause mortality, in the pooled analysis of patients with, or at a higher risk of, cardiovascular disease. In addition, its use decreases the incidence of fatal and nonfatal MI and revascularization, but not fatal and non-fatal stroke. Our analysis suggests benefits to IPE use in secondary, but not primary, prevention in reduction of major adverse cardiovascular events. CLINICAL IMPLICATIONS: There is mixed data on the clinical benefit of IPE use. However, our meta analysis denotes to suggest that IPE, inaddition to standard therapy, is beneficial in the prevention of major adverse cardiovascular events, but not in reducing the risk of cardiovascular mortality and all cause mortality. In high risk patients, the use was associated with decrease incidence of fatal and non-fatal MI and revasuclarization. Therefore, IPE may be used in secondary prevention in reduction of major adverse cardiovascular events. DISCLOSURES: No relevant relationships by Ronny Antony No relevant relationships by Simrat Batth No relevant relationships by Michael Bogart No relevant relationships by Samkit Jain No disclosure on file for Joseph Lieber No relevant relationships by Daniel Mozell No relevant relationships by Tanya Rastogi No relevant relationships by Vaibhav Shah No relevant relationships by Ranbir Singh No relevant relationships by David Song