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Decrease in triglyceride level by bezafibrate is related to reduction of recurrent coronary events: a Bezafibrate

Moti Haim1, Michal Benderly, Valentina Boyko

  • 1Cardiology Department, Rabin Medical Center, Petach-Tikva, Sackler School of Medicine, Tel-Aviv University, Israel.

Coronary Artery Disease
|July 18, 2006
PubMed
Summary

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Fibrates like bezafibrate reduce coronary events in patients with high triglycerides, but only when triglyceride levels are substantially lowered. The extent of triglyceride reduction directly correlates with risk reduction in these patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Metabolic Syndrome

Background:

  • Fibrates are known to reduce recurrent coronary events in patients with coronary heart disease (CHD) and elevated triglycerides.
  • The relationship between the degree of triglyceride reduction and the observed clinical benefit remains unclear.

Purpose of the Study:

  • To investigate whether the effectiveness of fibrates in reducing recurrent coronary events in CHD patients is linked to the extent of triglyceride reduction.
  • To analyze the association between baseline triglyceride levels, triglyceride reduction achieved with bezafibrate, and the risk of recurrent cardiovascular events.

Main Methods:

  • The Bezafibrate Infarction Prevention (BIP) study enrolled 3090 CHD patients.
  • Mean follow-up was 6.2 years, assessing fatal/nonfatal myocardial infarction and sudden death.

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Main Results:

  • Bezafibrate significantly reduced triglyceride levels, with greater reduction in patients with higher baseline levels.
  • A substantial triglyceride reduction (to <0.50 mmol/l) in patients with high baseline triglycerides (> or =2.26 mmol/l) was associated with a 55% risk reduction.
  • Patients treated with bezafibrate who had minimal triglyceride reduction showed no significant risk difference compared to placebo.

Conclusions:

  • Bezafibrate treatment significantly reduces risk in CHD patients with elevated triglycerides, but this benefit is contingent upon substantial triglyceride level reduction.
  • The extent of triglyceride lowering achieved with bezafibrate is a critical determinant of its efficacy in preventing recurrent coronary events.