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 .
Effect of gemfibrozil versus lovastatin on increased serum lipoprotein(a) levels of patients with hypercholesterolemia.
The aim of this study was to determine the effect of gemfibrozil , compared with lovastatin , in patients with high levels of lipoprotein(a ) and on plasma lipid profile . Twenty-seven nondiabetic patients with high levels of plasma lipids and lipoprotein(a ) , 19 male and eight female , aged 37 - 68 ( mean + /- S.D. 54.2 + /- 7.5 ) years , were r and omly assigned to 2 weeks of treatment with gemfibrozil 600 mg twice daily ( 14 pts . ) or lovastatin 40 - 80 mg once daily ( 13 pts . ) . Patients had fasting plasma total cholesterol levels > or = 6.2 mmol/l , low-density lipoprotein > 4.14 mmol/l and lipoprotein(a ) > 0.62 mmol/l . All patients but one had triglycerides > 2.82 mmol/l . There were no statistical differences between both groups in terms of age , sex , clinical diagnosis and previous medication . After 3 months of treatment , gemfibrozil reduced triglycerides ( 47.9 % vs. 24.5 % ; P < 0.001 ) , very low density lipoprotein ( 43.9 % vs. 24.6 % ; P < 0.05 ) , lipoprotein(a ) ( 25.3 % vs. 4.9 % ; P < 0.05 ) and increased high-density lipoprotein ( 34.4 % vs. 11 % ; P < 0.01 ) more than lovastatin . Gemfibrozil and lovastatin reduced comparably total cholesterol ( 21.4 % vs. 29.0 % ; P = NS ) and low-density lipoprotein ( 26.5 % vs. 37.3 % ; P = NS ) . The plasma levels of high-density lipoprotein and lipoprotein(a ) were unchanged significantly by lovastatin . In conclusion , besides well-known efficacy in hyperlipidemia treatment , gemfibrozil also increased high-density lipoprotein and reduced lipoprotein(a ) , which may have important epidemiologic implication
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 .