Background

The Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (REDUCE-IT) study demonstrated that 4 g/d of eicosapentaenoic acid (EPA) ethyl esters (icosapent ethyl [IPE]) reduced risk for major cardiovascular events by 25% in statin-treated patients with residual hypertriglyceridemia. How this treatment affected red blood cell (RBC) EPA and docosahexaenoic acid (DHA) levels (ie, the Omega-3 Index [O3I]) was not reported, but effects on plasma EPA concentrations were reported.

Objective

The aim of the study was to estimate baseline and final O3I levels in REDUCE-IT.

Methods

First, deidentified data from our laboratory on RBC and plasma EPA and DHA from 2311 patients with similar lipid profiles as those in REDUCE-IT were used to generate a regression equation, which was then used to estimate the O3I from plasma FA concentrations. Second, previously published data on the effects of IPE on RBC FA concentrations were also converted to the O3I.

Results

Both approaches (from calculations and prior publications) suggested that baseline and follow-up O3I levels were about 5% and 7%, respectively. In addition, plasma EPA levels (but not the O3I) were noted to be influenced by triglyceride levels.

Conclusion

For patients using 4 g of IPE, an estimated O3I value of about 7% reflects a cardioprotective state. Plasma EPA concentrations may be ill-suited as treatment targets because they are confounded by triglyceride levels.

中文翻译：

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在用二十碳五烯酸处理期间，将血浆二十碳五烯酸浓度转换为二十碳五烯酸加二十二碳六烯酸的红细胞百分比。

背景

异烟酸乙酯干预试验（REDUCE-IT）减少心血管事件的研究表明，在他汀类药物中，4 g / d的二十碳五烯酸（EPA）乙酯（二十碳五乙酯[IPE]）可将发生重大心血管事件的风险降低25％。残留高甘油三酯血症的患者。尚未报道这种治疗如何影响红细胞（RBC）EPA和二十二碳六烯酸（DHA）的水平（即Omega-3指数[O3I]），但已报道了对血浆EPA浓度的影响。

客观的

该研究的目的是评估REDUCE-IT中的基线和最终O3I水平。

方法

首先，使用来自我们实验室的关于23例血脂与REDUCE-IT相似的RBC和血浆EPA和DHA的不确定数据来生成回归方程，然后将其用于根据血浆FA浓度估算O3I。其次，先前发表的有关IPE对RBC FA浓度影响的数据也被转换为O3I。

结果

两种方法（从计算和先前的出版物中得出）都表明基线和后续O3I水平分别约为5％和7％。此外，血浆EPA水平（而不是O3I）被认为受甘油三酸酯水平的影响。

结论

对于使用4 g IPE的患者，估计的O3I值约为7％反映了心脏保护状态。血浆EPA浓度可能不适合作为治疗目标，因为它们与甘油三酸酯水平混淆。