Original Research
Saturday, October 12, 2024
11:30 AM–01:00 PM
Abstract
Introduction: Icosapent ethyl (IE), a lipid-regulating agent containing an ethyl ester of eicosapentaenoic acid (EPA) is indicated as adjunct to maximally tolerated statin therapy to reduce MACE outcomes in patients with established cardiovascular (CV) disease with elevated triglyceride levels. Previous RCTs have shown an association of IE to atrial fibrillation (AF), requiring hospitalization, higher in patients with prior AF.
Research Question or Hypothesis: IE will increase AF incidence in AF-naïve patients compared to omega-3-acid ethyl esters (DHA/EPA) in patients taking baseline-statin therapy.
Study Design:Observational cohort study
Methods: In this retrospective cohort study, the population consisted of individuals enrolled in the Merative MarketScan Commercial Claims and Medicare Supplemental Databases (2013-2021). Adult patients on statins who initiated IE or DHA/EPA were identified using outpatient-dispensing records. Patients with an AF diagnosis during the one-year baseline period were excluded. Patients were followed for two years to assess the incidence of AF. Censoring occurred if there was treatment discontinuation, switching between treatments, end of enrollment, or end of the study (prior to event). Patients experiencing events or being censored within the first 30 days were excluded. Propensity score matching was used to create comparable groups, with exact matching on periods (2013-2015, 2016-2018, and 2019-2021). Using Cox proportional hazard regression model, we calculated hazards ratio of the onset of AF for IE versus DHA/EPA.
Results: The analytic cohort consisted of 17,638 matched pairs. Patients in both groups had a median age of 56 years. Male patients accounted for a 65.7% of the IE group and 64.5% of the DHA/EPA group. Baseline cardiovascular risk factors were well-matched between groups. The 2-year cumulative incidence of AF for IE and DHA/EPA groups were 5.322% and 3.994%, respectively, calculating a HR of 1.257 [95% CI,1.159-1.364], p=0.0032.
Conclusion: IE is associated with a higher risk of AF compared to DHA/EPA.
Presenting Author
Samantha Patton N/AUniversity of Utah
Authors
Kibum Kim PhD
Michael Kim PharmD
University of Illinois Chicago College of Pharmacy
Mark Munger PharmD, FCCP
Przemyslaw Radwański PharmD, PhD, FAHA
Jyotirmoy Sarker MPharm, MBA
University of Illinois Chicago