What are the recommendations for treating hypertriglyceridemia?
In patients with ischemic stroke or TIA, with fasting triglycerides 135 to 499 mg/dL and LDL-C of 41 to 100 mg/dL, on moderate- or high-intensity statin therapy, with HbA1c <10%, and with no history of pancreatitis, AF, or severe heart failure, treatment with icosa- pent ethyl (IPE) 2 g twice a day is reasonable to reduce risk of recurrent stroke.219,220 In patients with severe hypertriglyceridemia (ie, fasting triglycerides 500 mg/dL [ 5.7 mmol/L]), it is reasonable to identify and address causes of hypertriglyceridemia and, if triglycerides are persistently elevated or increasing, to further reduce triglycerides in order to lower the risk of ASCVD events by implementation of a very low-fat diet, avoidance of refined carbohydrates and alcohol, consump- tion of omega-3 fatty acids, and, if necessary to prevent acute pancreatitis, fibrate therapy.221 223