Key result
Fibrate therapy significantly reduced nonfatal myocardial infarction by 22%, total cholesterol by 8%, and triglycerides by 30%, while increasing HDL cholesterol by 9%.
Why the study?
Does fibrate therapy improve lipid profiles and reduce cardiovascular disease risk in patients with dyslipidemia?
Meta-Analysis
Does fibrate therapy improve lipid profiles and reduce cardiovascular disease risk in patients with dyslipidemia?
Effect estimate: 22% reduction
Fibrate therapy effectively optimizes lipid profiles and reduces nonfatal myocardial infarction, though specific agents like clofibrate and gemfibrozil should be avoided due to adverse effects.
Supports fibrates for nonfatal MI reduction and lipid optimization in dyslipidemia; extends evidence but advises avoiding clofibrate and gemfibrozil.
Dyslipidemia increases the risk of cardiovascular disease (CVD) risk which is a leading cause of mortality. This creates the need for therapies to effectively manage dyslipidemia to decrease the CVD risk associated with it. This meta-analysis evaluates fibrate therapy in respect to dealing with dyslipidemia and CVD risk. Fibrates significantly reduced plasma total cholesterol by 8% and significantly reduced triglyceride levels by 30%. High density lipoprotein cholesterol levels were raised by 9% with fibrates. All-cause mortality and noncardiovascular mortality were both significantly increased with fibrates but these significant changes no longer appeared after trials using clofibrate were removed from the analysis. There was no significant reduction in fatal myocardial infarction but there was a significant 22% reduction of nonfatal myocardial infarction. Fibrates can effectively reduce low density lipoprotein C (LDL-C) while also optimizing high-density lipoprotein and triglyceride levels as well, which statins do not. Negative effects of fibrates were not significant after clofibrate trials were removed from consideration in the study. It should be noted that gemfibrozil should not be used as well due to its adverse effects.
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Loomba et al. (2010) conducted a meta-analysis in Dyslipidemia and cardiovascular disease risk. Fibrates was evaluated on Nonfatal myocardial infarction (22% reduction). Fibrate therapy significantly reduced nonfatal myocardial infarction by 22%, total cholesterol by 8%, and triglycerides by 30%, while increasing HDL cholesterol by 9%.
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