In patients with ASCVD receiving recommended statin therapy, residual cardiovascu- lar risk is present. Elevated triglycerides are associ- ated with such risk. Treatment to reduce triglycerides with extended-release niacin and fibrates in addition to statin therapy has not improved cardiovascular outcomes. However, IPE has been shown to reduce major adverse cardiovascular events (MACEs; ie, car- diovascular death, nonfatal MI, nonfatal stroke, coro- nary revascularization, or unstable angina), including ischemic stroke, when added to moderate- or high- intensity statin therapy in patients with LDL-C of 41 to 100 mg/dL. In this study, patient enrollment crite- ria included T2D with multiple risk factors for ASCVD (29%) or history of ASCVD (71%).219 Almost 60% of the entire cohort had T2D. Recommendation-Specific Supportive Text 1. The REDUCE-IT trial (Reduction of Cardiovascular Events With Icosapent Ethyl randomized 8179 patients with ASCVD including history of ischemic stroke or TIA (70%) or diabetes with other risk factors (30%) to IPE 2 g twice daily plus statin versus statin alone. Enrollment crite- ria included fasting triglycerides of 135 to 499 mg/dL and LDL-C of 41 to 100 mg/dL on statin dose for 4 weeks. Follow-up for a median of 4.9 years revealed a 25% reduction mary end point of MACEs. Results for nonfa- tal stroke and TIA were the same for MACEs. No difference occurred in hemorrhagic stroke. A small, significant increase in AF occurred in those treated with IPE (5.3% versus 3.9%). Because benefits were similar across base- line triglycerides and unrelated to triglyceride levels attained, the mechanism by which IPE reduces MACEs, including secondary preven- tion of stroke, is unknown, possibly related to factors other than lowering triglycerides. 