skip to main content

Icosapent Ethyl for Hypertriglyceridaemia — EECC MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHypertension & Preventive CardiologyIcosapent Ethyl for HypertriglyceridaemiaEECC

A 58-year-old man with very high cardiovascular risk (prior MI, diabetes) has triglycerides of 4.5 mmol/L despite statin therapy. His LDL-C is at target (1.3 mmol/L). Should icosapent ethyl be prescribed?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Yes — icosapent ethyl (purified EPA) is recommended (Class IIa) as add-on to statins for residual hypertriglyceridaemia (TG 1.5-5.6 mmol/L) in high/very-high risk patients, based on the REDUCE-IT trial

The REDUCE-IT trial demonstrated that icosapent ethyl (highly purified EPA 2 g bd) reduced the composite of cardiovascular death, MI, stroke, coronary revascularisation, and unstable angina by 25% in statin-treated patients with elevated TG (1.5-5.6 mmol/L) and established CVD or diabetes with risk factors. The 2019/2025 ESC/EAS Dyslipidaemia Guidelines include icosapent ethyl as a Class IIa recommendation for residual hypertriglyceridaemia in very-high-risk patients. Importantly, icosapent ethyl is NOT equivalent to over-the-counter fish oil supplements (which contain mixed EPA/DHA and showed no CV benefit in the STRENGTH trial using carboxilic acid formulation). Fibrates reduce TG effectively but have not consistently shown CV event reduction.

Reference: ESC/EAS (2019/2025): Dyslipidaemia Guidelines; REDUCE-IT Trial