The Effects of Pemafibrate on Fibrinogen and Thrombogenicity in Patients with Coronary Artery Disease

Figures

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  Supplementary Fig.1. Enrollment, Randomization, and Follow-up. Patients were randomly assigned in a 1:1 ratio to receive either pemafibrate 0.1mg twice daily (intervention group) or standard care without additional lipid-lowering therapy (control group). Randomization was performed after adjustment for the following factors: age (＜65 or ≥ 65 years old), fibrinogen level (＜300 or ≥ 300 mg per deciliter), and antiplatelet monotherapy (aspirin, clopidogrel, or prasugrel). FAS, full analysis set; PPS, per-protocol set.

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  Fig.1. Effects of Pemafibrate on Changes in the Fibrinogen levels. In these box-and-whisker plots, lines within the boxes represent median values; the upper and lower lines of the boxes represent the 75th and 25th percentiles, respectively; and the upper and lower bars outside the boxes represent the maximum and minimum values within 1.5 times the interquartile range from the 75th and 25th percentiles, respectively.

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  Fig.2. Effects of Pemafibrate on Changes in Thrombogenicity, Coagulation, and Inflammation Markers. In these box-and-whisker plots, lines within the boxes represent median values; the upper and lower lines of the boxes represent the 75th and 25th percentiles, respectively; and the upper and lower bars outside the boxes represent the maximum and minimum values within 1.5 times the interquartile range from the 75th and 25th percentiles, respectively. AR10-AUC30, area under the curve for the atheroma chip; PL18-AUC10, area under the curve for the platelet chip; t-PAI-1, total plasminogen activator inhibitor-1.

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  Fig.3. Effects of Pemafibrate on Changes in the Markers Related to Glucose Metabolism, Liver, and Renal Function. In these box-and-whisker plots, lines within the boxes represent median values; the upper and lower lines of the boxes represent the 75th and 25th percentiles, respectively; and the upper and lower bars outside the boxes represent the maximum and minimum values within 1.5 times the interquartile range from the 75th and 25th percentiles, respectively. UACR, urinary albumin-to-creatinine ratio.

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  Supplementary Fig.2. Effects of Pemafibrate on Percentage Changes in Parameters. In these box-and-whisker plots, lines within the boxes represent median values; the upper and lower lines of the boxes represent the 75th and 25th percentiles, respectively; and the upper and lower bars outside the boxes represent maximum and minimum values within 1.5 times the interquartile range from the 75th and 25th percentile, respectively. AR-AUC, area under the curve for the atheroma chip; PL-AUC, area under the curve for the platelet chip; t-PAI-1, tissue plasminogen activator inhibitor-1; UACR, urinary albumin-to-creatinine ratio.

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  Supplementary Fig.3. Group-Specific Correlation of 12-Week Percent Change in Lipid Parameters and Fibrinogen. These scatter plots show the association between percentage change in lipid parameters such as (a) triglyceride levels, (b) LDL-C levels, (c) HDL-C levels and percentage change in fibrinogen levels. To minimize the influence of outliers, the upper and lower 2% of percentage change in each parameter (n = 4) were trimmed prior to analysis. TG, triglyceride.

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  Central Illustration. Pemafibrate significantly reduced the fibrinogen levels in patients with CAD and hypertriglyceridemia after 12 weeks of treatment. However, an increase in thrombogenicity, as measured by T-TAS parameters, was observed in the pemafibrate group. Pemafibrate may offer some benefit in reducing thrombotic risk through its effect on fibrinogen; however, further research is needed to understand its impact on thrombogenicity, as indicated by the changes in the T-TAS parameters.