This week, our blog covers a new drug set to revolutionise care for patients at risk of a heart attack.
What?
NICE (the National Institute for Health and Care Excellence) is set to approve a new fat-lowering drug that can bring about dramatic reductions in the risk of patients having a heart attack. Icosapent ethyl, known by the brand name Vazkepa, lowers levels of a type of fat called triglyceride in the blood.
A clinical trial of icosapent ethyl involved around 20,000 participants where patients took either placebo or the trial drug, and were followed up for ~5 years to assess the effect on cardiovascular events such as heart attacks. Following analysis, icosapent ethyl was found to reduce the risk of a cardiovascular event by up to 25%.
Why?
For a number of years we have known that lower cholesterol (a type of fatty molecule in the blood stream) levels reduce the likelihood of having a heart attack or other cardiovascular event. Statins are an effective drug to reduce these levels and are widely prescribed currently – see myHSN’s blog about this subject. However, cholesterol is only part of the story.
Other fatty molecules exist in the bloodstream that can also increase the risk of a heart attack. These are known as triglycerides or TGs for short. TGs are not lowered by statins, and previous drugs that do lower TGs (e.g. fibrates) have not shown a long-term reduction in cardiovascular risk. Icosapent ethyl is therefore a highly important drug as it both lowers TGs and reduces cardiovascular risk.
The build up of TGs and cholesterol in the blood contribute to the build-up of ‘plaques’ in the arteries that cause them to narrow. When blood is unable to reach parts of the heart through its own blood supply (the coronary arteries), we experience this as chest pain.
If the artery is only narrowed, it is called angina. This can be relieved with sprays under the tongue, or with tablets. If the artery becomes blocked, this will lead to a part of heart muscle dying. This is commonly known as a heart attack, or a myocardial infarction (MI) (myo = muscle, cardial = heart, infarction = death). If chest pain does not go away despite the use of sprays or tablets, you should always call 999, or attend A&E straight away. It is therefore extremely important to reduce this risk by whatever means necessary.
How (does it affect you)?
If you are one of the 425,000 people in the UK taking a statin, but have high TG levels, this news will affect you. Your doctor should check your blood fat levels, and if your cholesterol is low, but TGs remain high, there is a good chance you will eligible for this treatment (if you are deemed at high risk of a cardiovascular event). Using figures from the initial clinical trials, this could mean reducing the risk of having a heart attack by up to 25%!
Drugs like icosapent ethyl and statins are prevention tools. They reduce risk by optimising the chemical state of the body, in turn making heart attacks less likely to happen. Most patients who have had a heart attack should also take these drugs to reduce the risk of a further event.
You may be aware of a number of other drugs, and may be taking them yourself. If you or a loved one are a current cardiology patient, read myHSN’s guide to good heart care to optimise the care you are receiving.
There is also advice on myHSN here about how to lower cholesterol and what you can do to help yourself.
As always, best wishes from myHSN!
