Stabilizing effect of combined eicosapentaenoic acid and statin therapy on coronary thin-cap fibroatheroma

Effects of the Addition of Eicosapentaenoic Acid to Strong Statin Therapy on Inflammatory Cytokines and Coronary Plaque Components Assessed by Integrated Backscatter Intravascular Ultrasound

“…Furthermore, a study using serial OCT observation reported the efficacy of EPA addition for the stabilization of atheroma. 36 This is consistent with our findings. In the future, the effects on advanced atheroma and on plaque stabilization should be further investigated.…”

“…35 A recent study reported that the concomitant use of EPA and rosuvastatin stabilized coronary thin-cap fibroatheroma better than the statin alone on serial optical coherence tomography (OCT). 36 In the present study, we demonstrated that combination treatment of EPA and a strong statin therapy stabilized plaque components assessed by IB-IVUS to a greater degree than did strong statin therapy alone. Our results may coincide with the OCT analyses.…”

Impact of Eicosapentaenoic Acid Treatment on the Fibrous Cap Thickness in Patients with Coronary Atherosclerotic Plaque: An Optical Coherence Tomography Study

“…In addition, Wu et al reported that EPA prevents the progression of atherosclerosis by reducing the level of oxidized LDL-induced cell apoptosis 18) . Therefore, the EPAinduced fibrous cap thickening observed in the present OCT study may be associated with a reduction in vascular inflammation and oxidative stress at sites of plaques than that observed with a statin alone 22) . In addition to these findings, the results of the present OCT study support the hypothesis that EPA therapy may prevent the progression of atherosclerosis.…”

Rationale and design of REDUCE‐IT: Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial

“…Furthermore, TG reduction lowers several inflammatory markers associated with CV risk, and subgroup and post hoc analyses of outcome studies suggest possible reductions in major CV events with TG‐lowering therapy 3, 4, 5, 6, 7, 8, 9, 10, 11. Finally, studies administering higher‐dose EPA suggest additional beneficial effects beyond lipid‐lowering that may be unique to EPA relative to other TG‐lowering therapies, such as beneficial changes in coronary plaque characteristics, which may lead to reductions in major CV events 4, 16, 25, 26, 27, 28, 29, 30, 31, 32, 33…”

“…In addition to beneficial changes to TG‐rich lipoproteins and other plasma lipid markers, some clinical studies with higher‐dose EPA also suggest beneficial effects on markers of oxidation and inflammation, coronary plaque characteristics, and major CV events 16, 25, 26, 29, 31, 32, 33. For example, in contrast to the fenofibrate and niacin studies, JELIS found a 19% relative risk reduction in CV events in statin‐treated patients with relatively normal TG but a more pronounced 53% reduction in the subgroup with mixed dyslipidemia, specifically TG ≥150 mg/dL and HDL‐C <40 mg/dL 4, 16.…”