Eligibility for marine omega-3 fatty acid supplementation after acute coronary syndromes

The 2019 European Society of Cardiology guidelines for the management of dyslipidemia consider the use of high-dose marine omega-3 fatty acid (FA) eicosapentaenoic acid (EPA) supplementation (icosapent ethyl 2 × 2g/day) to lower residual cardiovascular risk in high-risk patients with hypertriglyceri...

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Published in:Atherosclerosis plus 2024-12, Vol.58, p.1-8
Main Authors: Follonier, Cédric, Rabassa, Gabriel, Branca, Mattia, Carballo, David, Koskinas, Konstantinos, Heg, Dik, Nanchen, David, Räber, Lorenz, Klingenberg, Roland, Haller, Moa Lina, Carballo, Sebastian, Windecker, Stephan, Matter, Christian M., Rodondi, Nicolas, Mach, François, Gencer, Baris
Format: Article
Language:English
Subjects:
Acute coronary syndrome
Dyslipidemia
Full Length
Heart disease risk factor
Hypertriglyceridemia
Omega-3 fatty acids
Secondary prevention
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Summary:The 2019 European Society of Cardiology guidelines for the management of dyslipidemia consider the use of high-dose marine omega-3 fatty acid (FA) eicosapentaenoic acid (EPA) supplementation (icosapent ethyl 2 × 2g/day) to lower residual cardiovascular risk in high-risk patients with hypertriglyceridemia. This study aimed to assess the eligibility for omega-3 FA-EPA supplementation in patients with acute coronary syndromes (ACS). In a prospective Swiss cohort of patients hospitalized for ACS, eligibility for marine omega-3 FA-EPA, defined as plasma triglyceride levels ranging from 1.5 to 5.6 mmol/l, was assessed at baseline and one-year follow-up and compared across subgroups. Lipid-lowering therapy intensification with statin and ezetimibe was modelled to simulate a hypothetical systematic treatment and its effect on omega-3 FA-EPA supplementation eligibility. Of 2643 patients, 98 % were prescribed statin therapy at discharge, including 62 % at a high-intensity regimen; 93 % maintained it after one year, including 53 % at a high-intensity regimen. The use of ezetimibe was 3 % at discharge and 7 % at one year. Eligibility was observed in 32 % (32 % men, 29 % women) one year post-ACS. After modelling systematic treatment with statins, ezetimibe, and both, eligibility decreased to 31 %, 25 % and 24 %, respectively. Eligibility was higher in individuals aged
ISSN:2667-0895
2667-0909
2667-0895
DOI:10.1016/j.athplu.2024.09.002