Work

Widespread lipoprotein alterations in a REDUCE-IT like population: The icosapent ethyl (IPE)-NMR avatar study

Year: 2025

Type: article

Abstract: Background and aim Triglycerides (TG) are independent cardiovascular risk markers, yet TG-lowering therapies have failed to reduce major adverse cardiovascular events. However, high-dose icosapent ethyl (IPE) significantly reduces cardiovascular events in high-risk patients with controlled low-density lipoprotein cholesterol (LDL-C) and TG>1.7 mmol/L . Elevated TG levels contribute to widespread lipoprotein metabolism disruptions, which remain undetectable by standard lipid measures but can be characterized using proton nuclear magnetic resonance ( 1 H-NMR) spectroscopy. This study retrospectively analyses lipoprotein alterations in secondary prevention patients with characteristics similar to those in REDUCE-IT, using 1 H-NMR spectroscopy (Liposcale® test). Methods and results Patients from our institutional databases who had undergone advanced lipoprotein and glycoprotein profiling by 1 H-NMR spectroscopy were included. Criteria required a history of major cardiovascular events, lipid-lowering therapy, LDL-C between 1.04-2.6 mmol/L, and TG 1.7-5.7 mmol/L. Lipoprotein particle number, size, and composition and glycoproteins A and B were analysed by nuclear magnetic resonance (NMR). A total of 100 patients (25% female, mean age 63 years, 39% with diabetes) were selected. The Liposcale test identified significant lipoprotein disturbances, including increased atherogenic small TG-rich remnant lipoproteins and small LDL particles, as well as elevated remnant cholesterol and TG enrichment in high-density lipoprotein. These abnormalities were associated to increasing TG concentrations. The results were visualized through lipid silhouette analysis. Conclusion In secondary prevention patients resembling the REDUCE-IT cohort, 1 H-NMR profiling revealed extensive proatherogenic lipoprotein alterations associated to increasing TG concentrations. Further research is underway to assess whether IPE mitigates these disturbances beyond its TG-lowering effects.

Source: Nutrition Metabolism and Cardiovascular Diseases

DOI: 10.1016/j.numecd.2025.104199

Authors: Lluís Masana, Pol Torné, Xavier Garcia-Moll, Ernesto Dalli, Núria Amigó

Institutions: Universitat Rovira i Virgili, Universitat Autònoma de Barcelona, Hospital de Sant Pau, Hospital Arnau de Vilanova

Language: English

Topic: Lipoproteins and Cardiovascular Health

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,000