Eligibility of icosapent ethyl (EPA) in a French population of coronary outpatients with type 2 diabetes

Background and Aims: Background: Icosapent ethyl (EPA) is a lipid lowering treatment with proven clinical efficacy on major events in JELIS and REDUCE-IT studies. This innovative treatment has just been approved in France for ASCVD patients. But french data about clinical profiles of CAD outpatients with diabetes type 2 are lacking. Methods: We included 574 consecutive coronary patients with T2D in our prospective registry, most of our population was male (81%) with a high prevalence of other risk factors (81% with hypertension) and numerous cardiovascular comorbidities: mean age was 71 year-old, history of myocardial infarction was present in 47%, coronary revascularization in 78% or peripheral arterial disease in 16% of cases. Results: The lipid values were : mean serum total cholesterol 156 mg/dL, LDL cholesterol 85 mg/dL and triglycerides 148 mg/dL, with a mean glycated haemoglobin was 7.1%. 82% of patients received statins, with only 52% of high intensity statins, fibrates were prescribed for 1% of the population and ezetimibe only in 9% of cases despite guidelines, as only 37% reached a LDL-C below 70 mg/dL, and 19% under 55 mg/dL. According to the criteria of the National Lipid Association, 31% of coronary patients with T2D were eligible to a treatment by icosapent ethyl 4 grammes per day. Conclusions: In this contemporary survey with a non-selected coronary patients with diabetes, mainly treated by statins, 31% are potentially eligible to benefit from Icosapent Ethyl. These data also underline that only a minority reached LDL-C targets due to under prescription of lipid-lowering combinations.