What question did this study set out to answer?

To assess whether modifying lipid profiles by raising HDL-C and lowering triglycerides using bezafibrate reduces cardiovascular morbidity and mortality in coronary heart disease patients.

July 4, 2000Circulation

Secondary Prevention by Raising HDL Cholesterol and Reducing Triglycerides in Patients With Coronary Artery Disease

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Why the study?

Does bezafibrate reduce fatal or nonfatal myocardial infarction or sudden death in patients with coronary artery disease?

Population

3090 patients with a previous myocardial infarction or stable angina, total cholesterol of 180 to 250 mg/dL…

Comparison

Bezafibrate 400 mg per day vs Placebo

Design

RCT, randomized, double-blind

Follow-up

mean 6.2 years

Discussion

Member takes

Implication

Bezafibrate does not reduce MI or sudden death in CAD; does not support routine use and leaves open triglyceride-subgroup effects.

Key Points

To assess whether modifying lipid profiles by raising HDL-C and lowering triglycerides using bezafibrate reduces cardiovascular morbidity and mortality in coronary heart disease patients.
Double-blind trial randomizing 3,090 patients with prior myocardial infarction or stable angina to receive either 400 mg daily bezafibrate or placebo, with a mean follow-up of 6.2 years.
Eligible patients presented with total cholesterol of 180 to 250 mg/dL, HDL-C ≤45 mg/dL, triglycerides ≤300 mg/dL, and LDL-C ≤180 mg/dL.
Bezafibrate increased HDL-C by 18% and reduced triglycerides by 21%, but the reduction in the primary end point (fatal/nonfatal myocardial infarction or sudden death) was not statistically significant (13.6% vs 15.0%, P=0.26; 7.3% cumulative probability reduction, P=0.24).
In a post hoc subgroup analysis of patients with baseline triglycerides ≥200 mg/dL, bezafibrate yielded a 39.5% reduction in the cumulative probability of the primary end point (P=0.02).
Total and noncardiac mortality rates were similar between arms, and adverse events and cancer incidences were equally distributed.

Structured PICO

Does bezafibrate reduce fatal or nonfatal myocardial infarction or sudden death in patients with coronary artery disease?

Population

3090 patients with a previous myocardial infarction or stable angina, total cholesterol of 180 to 250 mg/dL, HDL-C ≤45 mg/dL, triglycerides ≤300 mg/dL, and low-density lipoprotein cholesterol ≤180 mg/dL

Intervention

Bezafibrate 400 mg per day

Comparator

Placebo

Outcome

Fatal or nonfatal myocardial infarction or sudden deathcomposite

Bezafibrate did not significantly reduce the primary composite endpoint of fatal or nonfatal MI or sudden death in patients with CAD, though a post hoc benefit was observed in those with high baseline triglycerides.

Cite This Study

A 2000 study studied this question.

synapsesocial.com/papers/6a7108d8f44fa9f079decba9 https://doi.org/10.1161/01.cir.102.1.21

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Secondary Prevention by Raising HDL Cholesterol and Reducing Triglycerides in Patients With Coronary Artery Disease

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Secondary Prevention by Raising HDL Cholesterol and Reducing Triglycerides in Patients With Coronary Artery Disease

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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