The estimated effects of fibrate therapy on plasma concentration and activity of PAI-1 were independent of treatment duration and changes in plasma triglyceride levels in the meta-regression analysis .
This meta- analysis of RCTs suggested that fibrate therapy does not reduce plasma concentration or activity of PAI-I. The putative benefits of fibrate therapy in patients with cardiovascular disease appear to be exerted via mechanisms independent of effects on PAI-1
OBJECTIVE The aim of this systematic review was to perform a meta- analysis of r and omized controlled trials ( RCTs ) examining the efficacy of fibrate therapy in reducing plasma concentration or activity of plasminogen activator inhibitor 1 ( PAI-1 ) .
Plasma homocysteine and the risk of venous thromboembolism: insights from the FIELD study
Abstract Background : The lipid-lowering effect of fenofibrate is accompanied by a rise in plasma homocysteine ( HCY ) , a potential risk factor for venous thromboembolism ( VTE ) . This study investigated the relationship between HCY and the risk of VTE in patients treated with fenofibrate .  Methods : The relationship between HCY and deep-vein thrombosis or pulmonary embolism was investigated in 9522 participants of the 5-year Fenofibrate Intervention and Event Lowering in Diabetes ( FIELD ) trial . All subjects received fenofibrate during a 6-week active run-in phase before r and omization . A Cox proportional-hazards model was used to assess the effect of HCY on risk of venous thromboembolic events . Results : During active-drug run-in , HCY rose on average by 6.5 μmol/L , accompanied by a substantial rise in plasma creatinine ( + 12 % ) . Fenofibrate-induced  changes in HCY and creatinine were fully reversible in the placebo group but persisted in the treatment group until reversing at the end of therapy . During follow-up , 1.8 % had at least one episode of deep-vein thrombosis or pulmonary embolism : 103 on fenofibrate and 68 on placebo ( log-rank p=0.006 ) . In multivariate analysis , every 5 μmol/L higher baseline HCY was associated with 19 % higher risk of VTE . Fenofibrate treatment was associated with 52 % higher risk , but the change in HCY with fenofibrate was not significantly associated with VTE after adjustment for baseline HCY . Conclusions : Hyperhomocysteinemia is prospect ively associated with  VTE . Fenofibrate may predispose individuals with high pretreatment HCY towards VTE . The fenofibrate-induced increase in HCY did not , however , explain the risk associated with fenofibrate therapy
The estimated effects of fibrate therapy on plasma concentration and activity of PAI-1 were independent of treatment duration and changes in plasma triglyceride levels in the meta-regression analysis .
This meta- analysis of RCTs suggested that fibrate therapy does not reduce plasma concentration or activity of PAI-I. The putative benefits of fibrate therapy in patients with cardiovascular disease appear to be exerted via mechanisms independent of effects on PAI-1
OBJECTIVE The aim of this systematic review was to perform a meta- analysis of r and omized controlled trials ( RCTs ) examining the efficacy of fibrate therapy in reducing plasma concentration or activity of plasminogen activator inhibitor 1 ( PAI-1 ) .