Arashi H, Yamaguchi J, Kawada-Watanabe E, et al. - Researchers investigated how clinical outcomes of patients with acute coronary syndrome are influenced by baseline eicosapentaenoic acid (EPA) to arachidonic acid (AA) ratio, via this subanalysis of the HIJ-PROPER (Heart Institute of Japan Proper Level of Lipid Lowering With Pitavastatin and Ezetimibe in Acute Coronary Syndrome) study. Random assignment of 1,734 patients with acute coronary syndrome and dyslipidemia to pitavastatin+ezetimibe therapy or pitavastatin monotherapy was done in the HIJ-PROPER study. Based on EPA/AA ratio on admission (cutoff 0.34 μg/mL as median of baseline EPA/AA ratio), the patients were categorized into 2 groups in this analysis, and their clinical results were evaluated, with primary endpoint being all-cause mortality, nonfatal myocardial infarction, nonfatal stroke, unstable angina pectoris, or ischemia-driven revascularization. An attenuated risk of cardiovascular events was reported in correlation with the addition of ezetimibe to statin vs statin monotherapy in acute coronary syndrome patients with dyslipidemia and low EPA/AA ratio.