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Effect of Fibrates on Lipid Profiles and Cardiovascular Outcomes: A Systematic Review
American Journal of Medicine, 09/29/09

Abourbih S et al. – In addition to improving lipid profiles, fibrates are associated with an important decrease in nonfatal myocardial infarction, but do not substantially affect all–cause mortality. Potential applications include treatment for patients with statin resistance or isolated hypertriglyceridemia, or as an adjunct to other lipid–lowering therapies.

• The authors systematically searched the literature to identify randomized, double–blind, placebo–controlled trials examining the effect of fibrates on lipid profiles or cardiovascular outcomes
• The authors estimated the effect of fibrates on the incidence of nonfatal myocardial infarction and all–cause mortality using random effects models.

• Compared with placebo, fibrates were associated with greater reductions in total cholesterol (range: ?101.3 mg/dL to ?5.0 mg/dL) and triglycerides (range: ?321.3 mg/dL to ?20.8 mg/dL), and a greater increase in high–density lipoprotein (range: +1.1 mg/dL to +17.9 mg/dL) in all trials.
• Fibrates tended to be associated with a greater reduction in low–density lipoprotein (range: ?76.3 mg/dL to +38.7 mg/dL) than placebo, although these results were not consistent across all trials.
• Fibrates were more efficacious than placebo at preventing nonfatal myocardial infarction, but not all–cause mortality.

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