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 .
Effects of simvastatin and ciprofibrate alone and in combination on lipid profile, plasma fibrinogen and low density lipoprotein particle structure and distribution in patients with familial combined hyperlipidaemia and coronary artery disease
Background Hypolipidaemic agents do not usually normalize all of the multiple lipoprotein abnormalities in patients with familial combined hyperlipidaemia ( FCHL ) . The effect of the simvastatin-ciprofibrate combination in comparison with each drug alone on the lipoprotein abnormality patterns was studied in patients with FCHL and coronary artery disease ( CAD ) . Methods Sixty patients ( 53 men and seven women ) , mean age 52 years ( range 36–60 years ) , were studied . After a 4-week placebo period , patients were r and omly assigned to three groups . The first group ( n = 20 ) received simvastatin ( 20 mg daily ) , the second group ( n = 20 ) ciprofibrate ( 100 mg daily ) and the third group ( n = 20 ) the combination of both drugs for a 1 2-week period . Parameters measured were as follows : plasma fibrinogen , total cholesterol , triglycerides , low density lipoprotein ( LDL ) , very low density lipoprotein , intermediate density lipoprotein , and high density lipoprotein cholesterol , as well as LDL subfraction distribution and structure by density gradient ultracentrifugation . Apoproteins ( apo ) B and Al were assessed by immunoturbidometry . Results At baseline , apoB , LDL cholesterol and triglycerides were increased , whereas LDL particles were small and dense . ApoB was significantly reduced by all three interventions . Drug combination and ciprofibrate significantly reduced plasma fibrinogen ( -24 and −25 % , respectively ; P < 0.001 ) and triglycerides ( -51 and −49 % , respectively ; P < 0.001 ) . Drug combination and simvastatin significantly reduced LDL cholesterol ( -25 and −22 % , respectively ; P < 0.001 ) compared with ciprofibrate ( -10 % ; P<0.01 ) . Ciprofibrate and drug combination  increased LDL particle size ( parameter K −0.24 versus −0.61 and −0.30 versus −0.62 , respectively ; P < 0.001 ) , whereas simvastatin had no significant effect on LDL particle size . The cholesterol content of LDL particles was reduced with ciprofibrate and the drug combination only in the dense LDL particles ( LDL3–5 ) and increased in the light ( LDL1–2 ) subfractions , whereas simvastatin reduced the cholesterol content of all LDL subfractions except LDL2 . Ciprofibrate and drug combination reduced the triglyceride content of al ! LDL subfractions . Conclusion Combined treatment with simvastatin and ciprofibrate  effectively reduced plasma fibrinogen , triglycerides , total and LDL cholesterol and increased LDL particle size in patients with FCHL and CAD . These effects might induce a clinical benefit for these patients
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 .