Effects of fibrates on cardiovascular events in large randomized controlled trials.
| Trial . | Drug . | Patient characteristics . | CV outcomea . | Trial duration (years) . | RR reduction entire cohort . | Atherogenic dyslipidemia subgroup . | RR reduction subgroupb . |
|---|---|---|---|---|---|---|---|
| HHS (90, 91) | Gemfibrozil | Non-HDL-C > 5.2 mmol/L No CHD Men | Nonfatal MI and CHD death | 5.0 | −34% (P < 0.02) | TG >204 mg/dL LDL-C/HDL-C ratio >5.0 | −71% (P = 0.005) |
| VA-HIT (92–94) | Gemfibrozil | HDL-C < 1.0 mmol/l CHD Men | Nonfatal MI and CHD death | 5.1 | −22% (P = 0.006) | TG >180 mg/dL <40 mg/dL | −30% (P < 0.05) |
| BIP (95) | Bezafibrate | Previous MI or angina Men and women | Fatal/nonfatal MI and sudden death | 6.2 | −7% (P = 0.26) | TG ≥200 mg/dL | −40% (P = 0.02) |
| FIELD (96, 97) | Fenofibrate | Type 2 diabetes Some patients receiving statins Men and women | MI, stroke, CVD death, coronary, or carotid revascularizationa | 5.0 | −11 (P = 0.035) | TG ≥204 mg/dL HDL-C < 40 mg/dL (men) or <50 mg/dL (women) | −27% (P = 0.005) |
| ACCORD (92, 98) | Fenofibrate | Type 2 diabetes CVD or >2 CVD risk factors Patients receiving simvastatin Men and women | Nonfatal MI, nonfatal stroke, and CVD death | 4.7 | −8% (P = 0.32) | TG ≥204 mg/dL HDL-C ≤ 34 mg/dL | −29% (P < 0.05) |
| Trial . | Drug . | Patient characteristics . | CV outcomea . | Trial duration (years) . | RR reduction entire cohort . | Atherogenic dyslipidemia subgroup . | RR reduction subgroupb . |
|---|---|---|---|---|---|---|---|
| HHS (90, 91) | Gemfibrozil | Non-HDL-C > 5.2 mmol/L No CHD Men | Nonfatal MI and CHD death | 5.0 | −34% (P < 0.02) | TG >204 mg/dL LDL-C/HDL-C ratio >5.0 | −71% (P = 0.005) |
| VA-HIT (92–94) | Gemfibrozil | HDL-C < 1.0 mmol/l CHD Men | Nonfatal MI and CHD death | 5.1 | −22% (P = 0.006) | TG >180 mg/dL <40 mg/dL | −30% (P < 0.05) |
| BIP (95) | Bezafibrate | Previous MI or angina Men and women | Fatal/nonfatal MI and sudden death | 6.2 | −7% (P = 0.26) | TG ≥200 mg/dL | −40% (P = 0.02) |
| FIELD (96, 97) | Fenofibrate | Type 2 diabetes Some patients receiving statins Men and women | MI, stroke, CVD death, coronary, or carotid revascularizationa | 5.0 | −11 (P = 0.035) | TG ≥204 mg/dL HDL-C < 40 mg/dL (men) or <50 mg/dL (women) | −27% (P = 0.005) |
| ACCORD (92, 98) | Fenofibrate | Type 2 diabetes CVD or >2 CVD risk factors Patients receiving simvastatin Men and women | Nonfatal MI, nonfatal stroke, and CVD death | 4.7 | −8% (P = 0.32) | TG ≥204 mg/dL HDL-C ≤ 34 mg/dL | −29% (P < 0.05) |
HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TG, triglycerides; T2D, Type 2 diabetes.
To convert TG from mg/dL to mmol/L, multiply by 0.0113; to convert HDL-C from mg/dL to mmol/L, multiply by 0.0259.
The CV outcome presented is the prespecified primary endpoint in all trials except FIELD. In this trial, the primary endpoint (CHD) was not reported in subgroups and the data are shown for the secondary endpoint of total CVD.
Risk reductions and P values for subgroups when not presented in publications by trial investigators were taken from the meta-analysis of Bruckert et al. (92).
Effects of fibrates on cardiovascular events in large randomized controlled trials.
| Trial . | Drug . | Patient characteristics . | CV outcomea . | Trial duration (years) . | RR reduction entire cohort . | Atherogenic dyslipidemia subgroup . | RR reduction subgroupb . |
|---|---|---|---|---|---|---|---|
| HHS (90, 91) | Gemfibrozil | Non-HDL-C > 5.2 mmol/L No CHD Men | Nonfatal MI and CHD death | 5.0 | −34% (P < 0.02) | TG >204 mg/dL LDL-C/HDL-C ratio >5.0 | −71% (P = 0.005) |
| VA-HIT (92–94) | Gemfibrozil | HDL-C < 1.0 mmol/l CHD Men | Nonfatal MI and CHD death | 5.1 | −22% (P = 0.006) | TG >180 mg/dL <40 mg/dL | −30% (P < 0.05) |
| BIP (95) | Bezafibrate | Previous MI or angina Men and women | Fatal/nonfatal MI and sudden death | 6.2 | −7% (P = 0.26) | TG ≥200 mg/dL | −40% (P = 0.02) |
| FIELD (96, 97) | Fenofibrate | Type 2 diabetes Some patients receiving statins Men and women | MI, stroke, CVD death, coronary, or carotid revascularizationa | 5.0 | −11 (P = 0.035) | TG ≥204 mg/dL HDL-C < 40 mg/dL (men) or <50 mg/dL (women) | −27% (P = 0.005) |
| ACCORD (92, 98) | Fenofibrate | Type 2 diabetes CVD or >2 CVD risk factors Patients receiving simvastatin Men and women | Nonfatal MI, nonfatal stroke, and CVD death | 4.7 | −8% (P = 0.32) | TG ≥204 mg/dL HDL-C ≤ 34 mg/dL | −29% (P < 0.05) |
| Trial . | Drug . | Patient characteristics . | CV outcomea . | Trial duration (years) . | RR reduction entire cohort . | Atherogenic dyslipidemia subgroup . | RR reduction subgroupb . |
|---|---|---|---|---|---|---|---|
| HHS (90, 91) | Gemfibrozil | Non-HDL-C > 5.2 mmol/L No CHD Men | Nonfatal MI and CHD death | 5.0 | −34% (P < 0.02) | TG >204 mg/dL LDL-C/HDL-C ratio >5.0 | −71% (P = 0.005) |
| VA-HIT (92–94) | Gemfibrozil | HDL-C < 1.0 mmol/l CHD Men | Nonfatal MI and CHD death | 5.1 | −22% (P = 0.006) | TG >180 mg/dL <40 mg/dL | −30% (P < 0.05) |
| BIP (95) | Bezafibrate | Previous MI or angina Men and women | Fatal/nonfatal MI and sudden death | 6.2 | −7% (P = 0.26) | TG ≥200 mg/dL | −40% (P = 0.02) |
| FIELD (96, 97) | Fenofibrate | Type 2 diabetes Some patients receiving statins Men and women | MI, stroke, CVD death, coronary, or carotid revascularizationa | 5.0 | −11 (P = 0.035) | TG ≥204 mg/dL HDL-C < 40 mg/dL (men) or <50 mg/dL (women) | −27% (P = 0.005) |
| ACCORD (92, 98) | Fenofibrate | Type 2 diabetes CVD or >2 CVD risk factors Patients receiving simvastatin Men and women | Nonfatal MI, nonfatal stroke, and CVD death | 4.7 | −8% (P = 0.32) | TG ≥204 mg/dL HDL-C ≤ 34 mg/dL | −29% (P < 0.05) |
HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TG, triglycerides; T2D, Type 2 diabetes.
To convert TG from mg/dL to mmol/L, multiply by 0.0113; to convert HDL-C from mg/dL to mmol/L, multiply by 0.0259.
The CV outcome presented is the prespecified primary endpoint in all trials except FIELD. In this trial, the primary endpoint (CHD) was not reported in subgroups and the data are shown for the secondary endpoint of total CVD.
Risk reductions and P values for subgroups when not presented in publications by trial investigators were taken from the meta-analysis of Bruckert et al. (92).
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