@mmillermd1 @PennCardiology @DLBHATTMD @UM_Cardiology @ASPCardio @nationallipid @BudoffMd @Medscape EPA effect on ASCVD in Japanese pts w/chronic CAD and EPA/AA ratios <0.4, on statins.

🐟EPA 1.8 gm (like JELIS)
🐟EPA baseline 46 ug/mL (JELIS, 96)
🐟All on statins, randomized to control or EPA, no blinding (like JELIS)

#aha22 1/ @AHAScience
@mmillermd1 @PennCardiology @DLBHATTMD @UM_Cardiology @ASPCardio @nationallipid @BudoffMd @Medscape @AHAScience N=2506

🐟interesting drop out rate/protocol deviation, covid era?
🐟LDL-C baseline, similar to reduce it
🐟EPA median 46 ug/mL, higher than reduce it (26), lower than Jelis (96).
🐟hsCRP ~0.40
2/ #aha22
@mmillermd1 @PennCardiology @DLBHATTMD @UM_Cardiology @ASPCardio @nationallipid @BudoffMd @Medscape @AHAScience 1,800 mg EPA
🐟46 ➡️ 145 ug/mL (26➡️150 ug/mL, reduce it)
🐟LDL-C, Trigs, HDL-C no change
🐟hsCRP went down in both
3/ #aha22
@mmillermd1 @PennCardiology @DLBHATTMD @UM_Cardiology @ASPCardio @nationallipid @BudoffMd @Medscape @AHAScience 🐟Respect-EPA estimated 30% RRR. Achieved a 21.5% in 1°, 26.5% in 2° endpts.
🐟NO mineral oil.
🐟Didn’t meet endpoint, underpowered.
🐟Achieved nearly Jelis-like similar ~20% RRR.
🐟Both groups on statins and LDL-C 80 mg/dL.
4/ #aha22
@mmillermd1 @PennCardiology @DLBHATTMD @UM_Cardiology @ASPCardio @nationallipid @BudoffMd @Medscape @AHAScience Nearly 20 years later in a population on statin, JELIS results are confirmed: 19-21% RRR w/ EPA 1800 mg.
🐟hsCRP similar
🐟effect in reduce-it, real. Magnitude🤷🏾‍♂️. Probably 15-20% RRR
🐟AF real
🐟 PCSK9I RRR is 15% 😉
5/5 #aha22 #epa #om3

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Make interprofessional practice a baseline. Implement this early and foundational to curricula.

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Nice work #STRENGTHTrial team! #OM3

First - primary endpoints not achieved. This is a sub-study.

Questions attempted to address:
- Could higher EPA explain favorable outcomes?

- Could DHA component have exactly counterbalanced benefits of EPA?

1/
#ACC21
Recall #STRENGTHtrial randomized 13,000+. Similar MACE outcomes to #REDUCEIT.

STRENGTH sub-study looks at top tertile achieved EPA and DHA compared to corn oil.'
2/
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-Interesting that high intensity statin use in top tertile was 10% less than other tertiles and corn oil group.

-LDL-C was 7 mg/dL higher in top tertile group than next highest (T1)

-Achieved EPA (443%) and DHA (68%) is c/w with dose 2200 mg, 800 mg respectively

3/
Read 10 tweets

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