menu-hamburger-svgrepo-com

Fenofibrate’s cardiovascular outcomes in statin users with metabolic syndrome

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

Kim et al (2019) set out to investigate whether fenofibrate as add-on to statin treatment reduce persistent cardiovascular risk in adults with metabolic syndrome in a real-world setting. 

Participants: 29 771 adults with metabolic syndrome (≥40 years) receiving statin treatment. 2156 participants receiving combined treatment (statin plus fenofibrate) were weighted based on propensity score in a 1:5 ratio with 8549 participants using statin only treatment.  

Main outcome measure: Primary outcome was composite cardiovascular events including incident coronary heart disease, ischaemic stroke, and death from cardiovascular causes.  

Results: The incidence rate per 1000 person years of composite cardiovascular events was 17.7 (95% confidence interval 14.4 to 21.8) in the combined treatment group and 22.0 (20.1 to 24.1) in the statin group. The risk of composite cardiovascular events was significantly reduced in the combined treatment group compared with statin group (adjusted hazard ratio 0.74, 95% confidence interval 0.58 to 0.93; P=0.01). The significance was maintained in the on-treatment analysis (hazard ratio 0.63, 95% confidence interval 0.44 to 0.92; P=0.02). The risk of incident coronary heart disease, ischaemic stroke, and cardiovascular death was lower in the combined treatment group than statin group but was not significant. Participant characteristics did not appear to be associated with the low risk of composite cardiovascular events with combined treatment. 

Conclusion  

In this propensity weighted cohort study of adults with metabolic syndrome, the risk of major cardiovascular events was significantly lower with fenofibrate as add-on to statin treatment than with statin treatment alone.  

What is already known on this topic? 

  • Randomised clinical trials of fenofibrate treatment have failed to show a reduction in risk of major cardiovascular events in people with diabetes, but a statistically significant cardiovascular risk reduction was observed in subgroups with atherogenic dyslipidaemia. 
  • Meta-analyses of fibrates also indicated that people with atherogenic dyslipidaemia would benefit from fibrates on cardiovascular events reduction. 
  • Real-world evidence was insufficient to prove the efficacy of fenofibrate in cardiovascular risk reduction especially in people of East Asian origin who are reported to be genetically susceptible to poor elimination of blood triglyceride. 

What this study adds 

  • The risk of major cardiovascular events was reduced in adults with metabolic syndrome using fenofibrate as add-on to statin treatment. 

REFERENCES:  

Kim N H, Han K H, Choi J, Lee J, Kim S G. Use of fenofibrate on cardiovascular outcomes in statin users with metabolic syndrome: propensity matched cohort study BMJ 2019; 366 :l5125 doi:10.1136/bmj.l5125 

Suggested Articles

Suggested Clinical & CPD content

CPD: 1pt

Related articles

Welcome to Medical Academic​

Get the most out of Medical Academic by telling us your occupation. This helps us create more great content for you and the community.

idea

1000’s of Clinical and CPD content compiled by Key Opinion Leaders and our expert medical editors.

connection

Access to medical webinars and events

Group 193

Access medical journals from industry leaders and expert medical editorials.

Congratulations! Your account was successfully created.

Please check your email for an activation mail. Click the activation link to activate your account

Stay up to date

Search for anything across CPD, webinars and journals
idea

1000’s of Clinical and CPD content compiled by Key Opinion Leaders and our expert medical editors.

connection

Access to medical webinars and events

Group 193

Access medical journals from industry leaders and expert medical editorials.

Congratulations! You have successfully booked your seat.

All webinar details will be emailed to your email address.

Did you know, you can book future webinars with a single click if you register an account with Medical Academic.

Congratulations! Your account was successfully created.

Your webinar seat has been booked and all webinar details will be emailed to your registered email address

Why not register for Medical Academic while booking your seat for this webinar?

Future Medical Academic webinars can be booked with a single click, all with a Medical Academic account… and it’s FREE.

Book webinar & create your account

* (Required)

idea

1000’s of Clinical and CPD content compiled by Key Opinion Leaders and our expert medical editors.

connection

Access to medical webinars and events

Group 193

Access medical journals from industry leaders and expert medical editorials.

Congratulations! Your account was successfully created.

Thank you for registering. You can now log in to your account.

Create your account

* (Required)

Login with One Time Pin (OTP)

Enter your registered email address to receive an OTP

We've sent your OTP