We proposed to evaluate the eligibility of patients presenting with Acute Ischemic Strokes (AIS) for Icosapent Ethyl (IPE) with regards to risk factors, demographics, and stroke subtype.

Hypertriglyceridemia (HTG) is known to be associated with metabolic syndrome and type 2 DM. It can result in accelerated atherosclerosis, a major stroke risk factor. IPE has been recently approved as a novel treatment for HTG in patients older than 45.

A total of 743 patients older than 45 admitted with AIS between Jan 2018 – Dec 2020 were identified.  Those on a statin at admission were categorized into eligible for IPE (LDL 41-100 and Triglyceride 150-499) vs. not eligible. Chi squared tests of proportion were performed to evaluate differences in demographics, risk factors, and stroke subtype between those eligible vs non eligible.

We identified 365 patients taking a statin on admission and 378 not on a statin. Of those that were on a statin at admission, 39 (5%) were eligible for IPE by LDL and TG criteria. Mean age of eligible patients was 68.5 and 51% were women. Patients eligible for IPE were more likely to be white (67% vs. 44%, p=0.006), have a history of DM (67% vs. 47%, p=0.018), and HTN (97% vs. 86%, p=0.042), as well as a trend for prior MI or CAD (46% vs. 33%, p=0.09). The most common stroke subtype in those eligible was cardioembolic (CE) (0.33%, p=.015).  

A substantial proportion of our population was not on a statin on admission underscoring the need for better primary prevention in these cases. About 5% of patients on a statin qualified for IPE. This population was more likely to have DM, HTN and CAD.  Stroke patients newly initiated on a statin should have follow-up TG measurement to assess eligibility for HTG treatment.