Monotherapy with either fibrates or statins suggested a significantly greater effect of fibrates in lowering plasma Fib concentrations .
According to these findings , mechanisms associated with fibrinogen metabolism might be responsible for the distinct effects of statins and fibrates in reducing cardiovascular endpoints
BACKGROUND Several studies suggest differences between fibrates and statins in lowering plasma fibrinogen ( Fib ) concentrations , but the evidence is not definitive .
Therefore , the aim of this meta- analysis of head-to-head r and omized trials was to compare the efficacy of statins and fibrates on plasma Fib concentrations .
Atherogenic risk reduction in patients with dyslipidaemia. comparison between bezafibrate and lovastatin.
OBJECTIVE To examine the atherogenic risk-reducing effect of bezafibrate and lovastatin . DESIGN , SETTING , PATIENTS , INTERVENTIONS Double-blind , r and omized clinical trial of male and female patients with moderate hypercholesterolaemia with or without hypertriglyceridaemia . Two months dietary treatment followed by 400 mg sustained release bezafibrate every day or 20 mg lovastatin every day for 6 months . Patients recruited ( n = 561 ) and treated ( n = 524 ) by primary care physicians throughout Austria . MAIN OUTCOME MEASURES Multifactorial assessment of atherogenic risk profile . RESULTS Bezafibrate increased high density lipoprotein cholesterol by 16 % , lovastatin by 10 % ( P < 0.05 ) . Bezafibrate decreased low density lipoprotein cholesterol by 20 % , lovastatin by 27 % ( P < 0.001 ) . Bezafibrate decreased total cholesterol by 15 % , lovastatin by 18 % ( P < 0.001 ) . Bezafibrate reduced triglycerides by 29 % , lovastatin by 13 % ( P < 0.001 ) ; and fibrinogen by 9.4 % and 3.0 % , respectively . Fibrinogen reduction as a result of bezafibrate administration was dependent on starting levels . The risk ratio cholesterol : high density lipoprotein cholesterol ( baseline both 6.1 ) reduction was 27 % in both groups . The low : high density lipoprotein ratio ( baseline : 4.1/4.2 ) reduction reached 31 % and 34 % respectively . Coronary events ' probability ( calculated from multifactorial risk functions ) were greatly reduced by both agents ( 41%/33 % ) . Hypertriglyceridaemic patients had a higher initial global coronary risk and profited more from treatment . Bezafibrate was significantly better tolerated ( P < 0.001 ) than lovastatin ; most events were gastrointestinal ( 6 vs 14 , ns ) or as a result of creatine phosphokinase elevations ( 3 vs 12 , P < 0.05 ) . CONCLUSIONS Both treatments significantly reduced the risk parameters for developing coronary heart disease , and calculated multifactorial coronary risk was similarly decreased . When selecting a drug for moderate dyslipidaemia and if haemostatic regulation is disturbed , the additional effect of bezafibrate on elevated fibrinogen levels should be considered
Monotherapy with either fibrates or statins suggested a significantly greater effect of fibrates in lowering plasma Fib concentrations .
According to these findings , mechanisms associated with fibrinogen metabolism might be responsible for the distinct effects of statins and fibrates in reducing cardiovascular endpoints
BACKGROUND Several studies suggest differences between fibrates and statins in lowering plasma fibrinogen ( Fib ) concentrations , but the evidence is not definitive .
Therefore , the aim of this meta- analysis of head-to-head r and omized trials was to compare the efficacy of statins and fibrates on plasma Fib concentrations .