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 .
Comparison of the effects of atorvastatin or fenofibrate on nonlipid biochemical risk factors and the LDL particle size in subjects with combined hyperlipidemia.
BACKGROUND Combined hyperlipidemia ( CH ) is an increasingly prevalent risk factor for premature heart disease , and its treatment is troublesome . The aim of this study was to compare the effects of atorvastatin and fenofibrate on nonlipid biochemical risk factors and the low-density lipoprotein ( LDL ) particle size in subjects with CH . METHODS Twenty-nine middle-aged men with CH were r and omly assigned to open-label therapy with atorvastatin ( 10 mg daily ) or micronized fenofibrate ( 200 mg daily ) ; they were sequentially treated with both drugs , with crossover of medication after 10 weeks . RESULTS Atorvastatin was more efficient in the reduction of total cholesterol , whereas fenofibrate was more efficient in the reduction of triglycerides . Only atorvastatin led to a significant reduction of LDL cholesterol and apolipoprotein B. Only fenofibrate increased high-density lipoprotein cholesterol . Neither drug influenced lipoprotein(a ) . Mean LDL particle size increased both after fenofibrate ( 3.08 % ) and atorvastatin ( 1.77 % ) . Fenofibrate increased serum homocysteine ( HCY ) by 36.5 % . Atorvastatin had no effect on HCY . Only atorvastatin increased fibrinogen by 17.4 % . Only fenofibrate reduced C-reactive protein by 51.7 % . Neither drug influenced HOMA ( homeostasis model assessment ) index of insulin resistance . The plasma level of thiobarbituric acid reactive substances , an index of oxidative stress , decreased after both treatments . CONCLUSIONS Both atorvastatin and fenofibrate had similar beneficial effects on LDL particle size and on oxidative stress . The effects of both drugs on other parameters such as triglycerides , total and high-density lipoprotein cholesterol , fibrinogen , or HCY differed significantly . These differences , together with the risk profile of a patient , should be considered during selection of a particular lipid-lowering modality
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 .