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Improvement in endothelial dysfunction in patients with hypoalphalipoproteinemia and coronary artery disease treated

J F Meco1, R Vila, R Pujol

  • 1Internal Medicine Department, Ciutat Santiària I Universitària de Bellvitge, Barcelona, Spain. jfmeco@csub.scs.es

Journal of Cardiovascular Pharmacology
|August 3, 2001
PubMed

Insights

Bezafibrate treatment improved endothelial function in patients with coronary artery disease and low high-density lipoprotein cholesterol (HDLc). This intervention increased HDLc and apolipoprotein A-I while decreasing fibrinogen levels, suggesting a potential therapeutic benefit.

Area of Science:

  • Cardiovascular Medicine
  • Lipid Metabolism
  • Endothelial Function Research

Background:

  • Isolated low high-density lipoprotein cholesterol (HDLc) is a recognized cardiovascular disease risk factor linked to arterial endothelial dysfunction.
  • While cholesterol-lowering therapies improve endothelial function in hypercholesterolemia, the impact of treating low HDLc remains under investigation.

Purpose of the Study:

  • To investigate the effect of increasing HDLc levels on endothelial function in patients diagnosed with coronary artery disease (CAD) and isolated low HDLc.
  • To assess the efficacy of bezafibrate in improving endothelial function and lipid profiles in this patient cohort.

Main Methods:

  • Study included 16 patients with CAD and impaired flow-mediated dilation (FMD) <10%.
  • Patients received bezafibrate (400 mg daily) for 6 months.
  • Brachial artery ultrasound was used to measure FMD before and after treatment.

Main Results:

  • Bezafibrate significantly increased HDLc (0.79 to 1.0 mM) and apolipoprotein A-I (1.04 to 1.19 g/l), while decreasing fibrinogen (4.45 to 3.39 g/l).
  • Flow-mediated dilation (FMD) improved significantly from a median of 2.5% to 12.3% after treatment.
  • Endothelial function normalized in 50% of patients, improved in 25%, and showed no change in 25%.

Conclusions:

  • Bezafibrate treatment effectively improves brachial artery endothelial function in patients with isolated low HDLc and CAD.
  • The observed improvements are associated with increased HDLc and apolipoprotein A-I, and reduced fibrinogen levels.
  • These findings suggest bezafibrate as a potential therapeutic option for managing endothelial dysfunction in this specific patient group.

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