Jan 2nd, 2024

In the field of pharmacotherapy for cardiovascular disease, recent studies have focused on the cost-effectiveness of cardiovascular drugs and the pharmacokinetics of common treatments. One such study examined the cost-effectiveness of Icosapent Ethyl in the REDUCE-IT USA participants. This participant-level and lifetime analysis utilized a Markov model to compare Icosapent Ethyl (IPE) with standard care (SC) in a population of 3146 patients. The results indicated that IPE led to an incremental gain in quality-adjusted life-years compared to SC and was associated with lower healthcare costs. These findings suggest that IPE is not only cost-effective but also provides better outcomes at lower costs, making it a viable option for US patients(1).

Another significant study in this domain focused on the use of Atorvastatin in patients undergoing percutaneous coronary intervention (PCI). This systematic review and meta-analysis encompassed 11 studies involving 5399 patients, divided into high-dose atorvastatin and control groups. The patient population included adult patients with STEMI or NSTEMI undergoing PCI. The intervention group received high-dose atorvastatin therapy, while the control group was subjected to placebo, standard care, or a different atorvastatin dose. The results revealed that high-dose atorvastatin pre-loading significantly reduced major adverse cardiac events (MACE) at one month and all-cause mortality in STEMI patients. This study highlights the protective effects of high-dose atorvastatin pre-loading in the short term for these patients (2).

In the area of pharmacokinetics, a meta-analysis was conducted to understand the factors influencing the pharmacokinetics and pharmacodynamics of Unfractionated Heparin (UFH) during cardiopulmonary bypass. This study, which aggregated individual patient data from two single-center prospective observational studies, focused on patients undergoing cardiac surgery with cardiopulmonary bypass. It found that UFH's pharmacokinetics and pharmacodynamics are best described by a two-compartment model, with UFH clearance being influenced by body weight and UFH type, and the volume of distribution affected by body weight and pre-operative fibrinogen levels. These findings offer a model for personalized UFH dosing in cardiopulmonary bypass patients, enhancing the precision of anticoagulation therapy by considering various individual factors (3).

1. Weintraub WS, Bhatt DL, Zhang Z, Dolman S, Boden WE, Bress AP, et al. Cost-Effectiveness of Icosapent Ethyl in REDUCE-IT USA: Results From Patients Randomized in the United States. J Am Heart Assoc. 2024;13(1):e032413.

2. García-Campa M, Flores-Ramírez R, Rojo-Garza S, Carrizales-Sepúlveda EF, Regalado-Ceballos D, Reyes-Araiza R, et al. Atorvastatin before percutaneous coronary intervention: A systematic review and meta-analysis. PLoS One. 2024;19(1):e0293404.

3. Gibert A, Lanoiselée J, Gouin-Thibault I, Pontis A, Azarnoush K, Petrosyan A, et al. Factors Influencing Unfractionated Heparin Pharmacokinetics and Pharmacodynamics During a Cardiopulmonary Bypass. Clin Pharmacokinet. 2024.