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Fibrates, Hypertriglyceridemia, and CVD Risk: Where Do We Stand After the PROMINENT Trial for Triglyceride Lowering?

  • Lipid Abnormalities and Cardiovascular Prevention (ED Michos, Section Editor)
  • Published:
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Abstract

Purpose of Review

To evaluate recent clinical trials focusing on patients with hypertriglyceridemia.

Recent Findings

Randomized clinical trials have recently been undertaken in hypertriglyceridemic patients to determine whether effective reductions in triglycerides would improve cardiovascular disease (CVD) outcomes. However, the fibric acid derivative, pemafibrate, failed to reduce cardiovascular events despite significant reductions (~ 25–35%) in triglyceride levels and despite background statin therapy. In contrast, icosapent ethyl, a highly purified omega-3 fatty acid was previously shown to reduce CVD events in hypertriglyceridemic patients, despite more modest reductions (~ 20%) in triglyceride levels in statin treated patients.

Summary

The divergent results obtained in patients with hypertriglyceridemia (HTG), a group at particularly high risk of CVD, especially when coupled with other risk factors, indicates that triglyceride lowering in of itself is insufficient to offset CVD risk. Rather, the effectiveness of therapy in this high-risk cohort may be the result of the suppression of the inherent atherogenic properties associated with HTG.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Funding

Funded in part by a VA Merit Award to Dr. Miller.

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Authors and Affiliations

  1. Department of Medicine, Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Marius I. Chukwurah & Michael Miller

  2. Corporal Michael J Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA

    Michael Miller

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  1. Marius I. Chukwurah
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Correspondence to Michael Miller.

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Dr. Miller is a scientific advisor for Amarin, Inc. and 89bio. Dr. Chukwurah declares no conflict of interest.

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Chukwurah, M.I., Miller, M. Fibrates, Hypertriglyceridemia, and CVD Risk: Where Do We Stand After the PROMINENT Trial for Triglyceride Lowering?. Curr Cardiol Rep 25, 987–992 (2023). https://doi.org/10.1007/s11886-023-01926-2

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