Key result
Clofibrate increases recurrent cerebral infarction versus placebo despite an associated decrease in mortality.
Why the study?
Does clofibrate 2 gm daily reduce morbidity and mortality due to atherosclerotic vascular disease in men with established cerebral infarction or TIA?
RCT (n=532)
random basis
Yes
Does clofibrate 2 gm daily reduce morbidity and mortality due to atherosclerotic vascular disease in men with established cerebral infarction or TIA?
In men with prior cerebrovascular disease, clofibrate therapy increased recurrent cerebral infarctions but decreased overall mortality, failing to support prior claims that it reduces myocardial ischemia.
Clofibrate should not be used after cerebral infarction or TIA; challenges earlier claims of benefit on atherosclerotic vascular disease.
A cooperative study in 20 Veterans Administration hospitals investigated the effect of clofibrate on morbidity and mortality due to atherosclerotic vascular disease in men with either an established cerebral infarction or transient cerebrovascular ischemic attacks (TIA). Follow-up observations were made for up to 4.5 years in 532 patients assigned on a random basis to placebo medication or to treatment with 2 gm of clofibrate daily. Baseline and follow-up cholesterol and triglyceride levels were measured. Recurrence of cerebral infarction was increased in patients receiving clofibrate as compared to controls. The incidence of new myocardial infarction and new TIA was similar in both groups. Despite the more frequent strokes in treated patients, they had a decrease in mortality, partially explained by a lower death rate from these recurrences. There was no correlation between pretreatment lipid (cholesterol and triglyceride) values and the result of therapy. Use of clofibrate, however, was associated with a slight reduction of cholesterol and a sustained fall in triglyceride. These findings do not support recently published reports that clofibrate reduces the occurrence of myocardial ischemia; however, the investigative design and type of data collected in these various studies are different and make it difficult to compare results.
No takes yet. Share an insight, caveat, or question.
A 1973 study conducted an RCT in Cerebrovascular disease (cerebral infarction or TIA) (n=532). Clofibrate vs. Placebo was evaluated on Morbidity and mortality due to atherosclerotic vascular disease. Clofibrate (2 gm daily) increased the recurrence of cerebral infarction compared to placebo, despite being associated with a decrease in mortality.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: