There is currently growing attention being paid to the role of elevated triglycerides (TGs) as important mediators of residual atherosclerotic cardiovascular disease (ASCVD) risk. This role is supported by genetic studies and by the persistent residual risk of ASCVD, even after intensive statin therapy. Although TG lowering drugs have shown conflicting results when tested in cardiovascular outcome trials, data from the REDUCE-IT study with the ethyl ester of ω-3 eicosapentaenoic acid (EPA) have revived hope in this area of research. The aim of the present review is to critically discuss the most recent large trials with ω-3 fatty acids (FAs) trying to elucidate mechanistic and trial-related differences, as in the case of REDUCE-IT and STRENGTH studies. The ω-3 FAs may lower cardiovascular risk through a number of pleiotropic mechanisms, e.g., by lowering blood pressure, by mediating antithrombotic effects, by providing precursors for the synthesis of specialized proresolving mediators that can inhibit inflammation or by modulating the lipid rafts enriched in cholesterol and sphingolipids. In conclusion, in a field fraught with uncertainties, the ω-3 FAs and especially high dose icosapent ethyl (the ethyl ester of EPA) are at present a most valuable approved therapeutic option to reduce the ASCVD risk.

OMEGA-3 AND CARDIOVASCULAR PREVENTION - IS THIS STILL A CHOICE? / M. Ruscica, C.R. Sirtori, S. Carugo, P.C. Calder, A. Corsini. - In: PHARMACOLOGICAL RESEARCH. - ISSN 1043-6618. - 182:(2022 Aug), pp. 106342.1-106342.14. [10.1016/j.phrs.2022.106342]

OMEGA-3 AND CARDIOVASCULAR PREVENTION - IS THIS STILL A CHOICE?

M. Ruscica
Primo
Writing – Original Draft Preparation
;
C.R. Sirtori
Secondo
Writing – Original Draft Preparation
;
S. Carugo
Writing – Review & Editing
;
A. Corsini
Ultimo
Writing – Review & Editing
2022

Abstract

There is currently growing attention being paid to the role of elevated triglycerides (TGs) as important mediators of residual atherosclerotic cardiovascular disease (ASCVD) risk. This role is supported by genetic studies and by the persistent residual risk of ASCVD, even after intensive statin therapy. Although TG lowering drugs have shown conflicting results when tested in cardiovascular outcome trials, data from the REDUCE-IT study with the ethyl ester of ω-3 eicosapentaenoic acid (EPA) have revived hope in this area of research. The aim of the present review is to critically discuss the most recent large trials with ω-3 fatty acids (FAs) trying to elucidate mechanistic and trial-related differences, as in the case of REDUCE-IT and STRENGTH studies. The ω-3 FAs may lower cardiovascular risk through a number of pleiotropic mechanisms, e.g., by lowering blood pressure, by mediating antithrombotic effects, by providing precursors for the synthesis of specialized proresolving mediators that can inhibit inflammation or by modulating the lipid rafts enriched in cholesterol and sphingolipids. In conclusion, in a field fraught with uncertainties, the ω-3 FAs and especially high dose icosapent ethyl (the ethyl ester of EPA) are at present a most valuable approved therapeutic option to reduce the ASCVD risk.
REDUCE-IT; STRENGTH; icosapent ethyl; inflammation; ω-3 fatty acids
Settore MED/04 - Patologia Generale
Settore BIO/14 - Farmacologia
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
4-lug-2022
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/933355
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