At EASD 2025, investigators presented a post hoc analysis of the REDUCE-IT trial, which enrolled over 8,100 statin-treated patients with mild-to-moderate hypertriglyceridemia, controlled LDL-C, and either diabetes with risk factors or established cardiovascular disease. The aim was to assess whether baseline triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, influenced treatment outcomes with icosapent ethyl (2 g twice daily).
Key results:
- Placebo patients with higher baseline TyG indices had increased CV event rates.
- Icosapent ethyl consistently reduced the primary endpoint (CV death, nonfatal MI, nonfatal stroke, coronary revascularization, or unstable angina) across TyG tertiles:
- Lower: HR 0.81 (95%CI 0.68–0.97).
- Middle: HR 0.70 (95%CI 0.59–0.83).
- Upper: HR 0.74 (95%CI 0.63–0.87).
- Similar results were seen for the secondary endpoint (CV death, nonfatal MI, nonfatal stroke).
- The benefit was also consistent in the secondary prevention subgroup (n=5,779).
Clinical context: These findings highlight that icosapent ethyl reduces cardiovascular risk regardless of baseline insulin resistance, supporting its broad utility in high-risk patients.
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References:
Aggarwal R, Bhatt DL, Ballantyne CM, et al. Efficacy of icosapent ethyl across the spectrum of baseline triglyceride-glucose indices: a post-hoc analysis of REDUCE-IT. Diabetologia. 2025;68(Suppl 1):S—S. Abstract OP04.