Conclusions Fibrates have a significantly greater effect in reducing plasma Lp(a ) concentrations than statins .
Addition of fibrates to statins can enhance the Lp(a)-lowering effect of statins
Background Raised plasma lipoprotein(a ) ( Lp(a ) ) concentration is an independent and causal risk factor for atherosclerotic cardiovascular disease .
Several types of pharmacological approaches are under evaluation for their potential to reduce plasma Lp(a ) levels .
There is suggestive evidence that statins and fibrates , two frequently employed lipid-lowering drugs , can lower plasma Lp(a ) .
The present study aims to compare the efficacy of fibrates and statins in reducing plasma concentrations of Lp(a ) using a meta- analysis of r and omized head-to-head trials .
Post-prandial effects of gemfibrozil vs simvastatin in hypercholesterolemic subjects with borderline hypertriglyceridemia.
BACKGROUND AND AIM Impaired triglyceride-rich lipoprotein metabolism is most probably related to an enhanced cardiovascular risk , and may be associated with a pro-coagulant state . A double-blind , r and omized study was undertaken to evaluate two widely utilized hypolipidemic drugs in the post-pr and ial phase and their impact on lipid , coagulation and fibrinolytic parameters . METHODS AND RESULTS Thirty middle-aged men selected according to their low density lipoprotein-cholesterol ( LDL-C ) > or = 160 and < or = 240 mg/dl and borderline hypertriglyceridemia ( 110 - 220 mg/dl ) after at least one month of a lipid-lowering diet received gemfibrozil ( 600 mg bid ) or simvastatin ( 20 mg qd ) and the corresponding placebo . On enrollment and after 2 months of drug treatment , they were tested with a st and ard oral fat load ( OFL ) ( 35 g fat/m2 body surface ) . On both occasions plasma total-cholesterol , LDL-C , HDL-C , triglycerides , lipoprotein[a ] ( Lp[a ] ) , tissue plasminogen activator ( tPA ) , plasminogen activator inhibitor-1 ( PAI-1 ) , antithrombin-III ( AT-III ) , plasminogen and fibrinogen were determined just before the meal ( t0 ) and at times 2 hours , 4 h , 6 h , 8 h after it ( t2-t8 ) . A two-factor ( time and visit ) multivariate analysis for repeated measurements was performed to evaluate the data . Total cholesterol , and LDL-C were significantly diminished 2 months after both gemfibrozil and simvastatin , the latter being more active . Plasma triglycerides showed a marked reduction with gemfibrozil at all times , while simvastatin regimen yielded only minor modifications . HDL-C was only slightly increased by simvastatin ;  Lp[a ] plasma levels were almost unaffected . Small fibrinogen ( t0 , t2 , t6 , t8 ) , PAI-1 ( t6 ) and AT III ( t0-t8 ) increases were observed after gemfibrozil , while simvastatin did not significantly modify these parameters . CONCLUSIONS In the post-pr and ial phase , gemfibrozil and simvastatin induce different metabolic effects that beneficially influence the lipid pattern , whereas fibrinolytic and coagulative parameters display minor variations of undetermined significance
Conclusions Fibrates have a significantly greater effect in reducing plasma Lp(a ) concentrations than statins .
Addition of fibrates to statins can enhance the Lp(a)-lowering effect of statins
Background Raised plasma lipoprotein(a ) ( Lp(a ) ) concentration is an independent and causal risk factor for atherosclerotic cardiovascular disease .
Several types of pharmacological approaches are under evaluation for their potential to reduce plasma Lp(a ) levels .
There is suggestive evidence that statins and fibrates , two frequently employed lipid-lowering drugs , can lower plasma Lp(a ) .
The present study aims to compare the efficacy of fibrates and statins in reducing plasma concentrations of Lp(a ) using a meta- analysis of r and omized head-to-head trials .