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

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.

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.