Generalizability of the REDUCE-IT trial to South Asians with cardiovascular disease.

South Asians (SAs) represent ∼25% of the world's population and account for >50% of global cardiovascular (CV) deaths, yet they continue to be underrepresented in contemporary clinical trials. The REDUCE-IT study demonstrated in a high-risk and predominantly White population that icosapent ethyl (IPE) lowered major adverse cardiovascular events by 25%. We sought to determine the generalizability of these results to a high-risk population of SAs with established CV disease living in Canada. This was a cross-sectional observational study of 200 statin-treated SAs (≥45 years) with atherosclerotic CV disease (ASCVD) (NCT05271591). SA ethnicity was self-identified as being of Anglo-Indian, Bangladeshi, Bengali, Bhutanese, Goan, Gujarati, Indian, Jatt, Kashmiri, Maharashtrian, Malayali, Nepali, Pakistani, Punjabi, Sindhi, Sinhalese, Sri Lankan, Tamil, Telugu, or other SA. ASCVD was defined as the presence of coronary, carotid, or peripheral atherosclerosis. Mean age of the cohort was 67 years, where 82% were men and 57% had diabetes. The predominant ASCVD phenotype was coronary artery disease (94%). Mean (SD) baseline LDL-C and triglycerides were 1.70 (0.8) mmol/L and 1.42 (1.0) mmol/L, respectively. Three-quarters were on high-intensity statin therapy. According to the Health Canada/Canadian Cardiovascular Society Guidelines and FDA-approved indication, 33% and 25% of the participants were, respectively, eligible for IPE. A large proportion of high-intensity, statin-treated, high-risk patients with ASCVD and of self-reported SA ethnicity are eligible for IPE. These data have important translational implications for SAs who are at a disproportionately higher risk of CV morbidity and mortality. This study was funded by an unrestricted grant provided by HLS Therapeutics Inc, Canada. Copyright © 2022 Elsevier Inc. All rights reserved.

Citation

Aishwarya Krishnaraj, Ehab Bakbak, Hwee Teoh, Deepak L Bhatt, Adrian Quan, Pankaj Puar, Bhaavani Lambotharan, Aathmika Kirubaharan, Irene N Firoz, Gus Meglis, Bobby Yanagawa, Basel Bari, Rajaratnam Kirubaharan, Ram Vijayaraghavan, David A Hess, Andrew M Demchuk, G B John Mancini, Jean-François Tanguay, Jean-Claude Tardif, Pierre Voisine, Lawrence A Leiter, Subodh Verma. Generalizability of the REDUCE-IT trial to South Asians with cardiovascular disease. Med (New York, N.Y.). 2023 Feb 10;4(2):130-138.e1

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PMID: 36630964

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