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 atorvastatin versus fenofibrate on lipoprotein profiles, low-density lipoprotein subfraction distribution, and hemorheologic parameters in type 2 diabetes mellitus with mixed hyperlipoproteinemia.
Diabetic dyslipoproteinemia characterized by hypertriglyceridemia , low high-density lipoprotein ( HDL ) cholesterol , and often elevated low-density lipoprotein ( LDL ) cholesterol with predominance of small , dense LDL is a strong risk factor for atherosclerosis . It is unclear whether fibrate or statin therapy is more effective in these patients . We compared atorvastatin ( 10 mg/day ) with fenofibrate ( 200 mg/day ) , each for 6 weeks separated by a 6-week washout period in 13 patients ( 5 men and 8 women ; mean age 60.0+/-6.8 years ; body mass index 30.0+/-3.0 kg/m2 ) with type 2 diabetes mellitus ( hemoglobin A1c 7.3+/-1.1 % ) and mixed hyperlipoproteinemia ( LDL cholesterol 164.0+/-37.8 mg/dl , triglycerides 259.7+/-107 mg/dl , HDL cholesterol 48.7+/-11.0 mg/dl ) using a r and omized , crossover design . Lipid profiles , LDL subfraction distribution , fasting plasma viscosity , red cell aggregation , and fibrinogen concentrations were determined before and after each drug . Atorvastatin decreased all LDL subfractions ( LDL cholesterol , -29 % ; p < 0.01 ) including small , dense LDL .  Fenofibrate predominantly decreased triglyceride concentrations ( triglycerides , -39 % ; p < 0.005 ) and induced a shift in LDL subtype distribution from small , dense LDL ( -31 % ) to intermediate-dense LDL ( + 36 % ) . The concentration of small , dense LDL was comparable during therapy to both drugs ( atorvastatin 62.8+/-19.5 mg/dl , fenofibrate 63.0+/-18.1 mg/dl ) . Both drugs induced an increase in HDL cholesterol  ( atorvastatin + 10 % , p < 0.05 ; fenofibrate + 11 % , p = 0.06 ) . In addition , fenofibrate decreased fibrinogen concentration ( -15 % , p < 0.01 ) associated with a decrease in plasma viscosity by 3 % ( p < 0.01 ) and improved red cell aggregation by 15 % ( p < 0.05 ) , whereas atorvastatin did not affect any hemorheologic parameter . We conclude that atorvastatin and fenofibrate can improve lipoprotein metabolism in type 2 diabetes . However , the medications affect different aspects of lipoprotein metabolism
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 .