Icosapent ethyl significantly reduces cardiovascular risk in patients with a history of smoking

New research suggests that icosapent ethyl may significantly reduce cardiovascular risk in former or current smokers with other cardiovascular risk factors.

Patients with a history of smoking experienced a significant reduction in the risk of a cardiovascular event on icosapent ethyl (Vascepa/Vazkepa; Amarin), according to a recent study by Amarin Corporation. These data were published in EHJ Cardiovascular Pharmacotherapy after being presented at the Congress of the European Society of Cardiology 2022.

“Although smoking cessation should always be recommended as a first step to reduce the risk of cardiovascular events, these data raise the possibility that treatment with icosapent ethyl may reduce excess cardiovascular risk in patients with a history of smoking, or current smokers, and other cardiovascular disease risk factors,” said Michael Miller, MD, cardiologist and chief medical officer, Corporal Michael J Crescenz Veterans Affairs Medical Center and vice president of medicine, Hospital from the University of Pennsylvania in Philadelphia, in a press release.

Deaths from cardiovascular disease (CVD) continue to rise in the United States. More than 800,000 heart attacks occur each year and the stroke rate is 795,000 cases per year. In total, more than 800,000 patients in the United States die each year from CV disease, underscoring the importance of reducing risk in current and former smokers.

Controlling low-density lipoprotein cholesterol (LDL-C) has been shown to reduce fatal cardiovascular events, such as heart attacks or strokes. Statin therapy has been shown to control elevated LDL-C and reduce the risk of death by up to a third, but millions of patients are still at significant risk of CV events with therapy.

In the REDUCE-IT trial, the researchers aimed to analyze the effects of icosapent ethyl on a patient’s risk of CV events if they had a history of previous or current smoking. As a global CV outcomes study, it evaluated icosapent ethyl on adult patients who were already taking statin therapy to control elevated LDL-C.

The team of investigators examined 8179 patients worldwide over the course of 7 years. Participants in this FDA-assigned special protocol evaluation agreement also had numerous cardiovascular risk factors, including elevated triglyceride levels between 135 and 499 mg/dL, diabetes mellitus or established cardiovascular disease, and 1 or several other risk factors.

The participants were divided into groups, which included people who had never smoked (the control group), former smokers and current smokers. Icosapent ethyl was given to current and former smokers, who were compared to the placebo group of never smokers.

According to the post hoc analysis, treatment with icosapent ethyl reduces the risk of CV events by almost 24% in current smokers, which is equivalent to a 25.7% improvement in non-smokers. The risk of CV death, myocardial infarction, stroke, coronary revascularization and unstable angina in current or former smokers also decreased by 23%. This risk was reduced to 29% in former smokers.

REDUCE-IT was limited because it was not powered for subgroup analyses.

“These data from the REDUCE-IT subgroup provide us with valuable insight into the role that PEI may play in helping to reduce the risk of cardiovascular events in patients with a history of smoking to levels seen in those who do not ‘never smoked,” Miller concluded in the press. Release.


Amarin. New data from Reduce-It® shows that Vascepa®/Vazkepa® (icosapent ethyl) reduced cardiovascular events in patients who smoke or have smoked. Amarin Corp website. August 28, 2022. Accessed August 29, 2022. https://investor.amarincorp.com/news-releases/news-release-details/new-reduce-itr-data-show-vasceparvazkepar-icosapent-ethyl-0