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The benefit of fibrates in the treatment of 'bad HDL-C responders to statins'.
Int J Cardiol. 2005 May 25; 101(2):231-5.IJ

Abstract

BACKGROUND

Lowering high levels of low-density lipoprotein cholesterol (LDL-C) is the primary aim in the prevention of cardiac events. However, low levels of high-density lipoprotein cholesterol (HDL-C) are also associated with an increased risk of ischemic heart disease. Some patients have lower HDL-C during statin treatment than before the treatment. These patients were first described in 2002 as 'bad HDL-C responders to statins'. The aim of this study was to describe the benefit of fibrates in monotherapy for these patients.

METHODS

A cross-sectional survey of lipid levels, cardiovascular disease and risk factors in outpatients treated for dyslipidemia. For this study we analyzed the lipid levels, drug treatment and medical history for 14 patients with low HDL-C (<40 mg/dl) during statin treatment and ever treated with fibrates.

RESULTS

Total cholesterol (TC) and LDL-C were respectively 8% and 6% higher with fibrates compared to statins. Mean HDL-C was 49% higher during fibrate treatment and TC to HDL-C and LDL-C to HDL-C were respectively 26% and 27% lower with fibrates.

CONCLUSIONS

Patients with low levels of HDL-C during statin treatment had far better levels for HDL-C, TC to HDL-C and LDL-C to HDL-C with fibrates in monotherapy. For bad HDL-C responders to statins with low or normal LDL-C treatment with fibrates instead of statins should be considered. For those with high LDL-C fibrates should be added to statins. A randomized double-blind crossover trial with simvastatin and fenofibrate has been initiated to corroborate these findings.

Authors+Show Affiliations

Department of General Practice, University of Brussels (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium. dirk.devroey@vub.ac.beNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15882669

Citation

Devroey, Dirk, et al. "The Benefit of Fibrates in the Treatment of 'bad HDL-C Responders to Statins'." International Journal of Cardiology, vol. 101, no. 2, 2005, pp. 231-5.
Devroey D, Velkeniers B, Duquet W, et al. The benefit of fibrates in the treatment of 'bad HDL-C responders to statins'. Int J Cardiol. 2005;101(2):231-5.
Devroey, D., Velkeniers, B., Duquet, W., & Betz, W. (2005). The benefit of fibrates in the treatment of 'bad HDL-C responders to statins'. International Journal of Cardiology, 101(2), 231-5.
Devroey D, et al. The Benefit of Fibrates in the Treatment of 'bad HDL-C Responders to Statins'. Int J Cardiol. 2005 May 25;101(2):231-5. PubMed PMID: 15882669.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The benefit of fibrates in the treatment of 'bad HDL-C responders to statins'. AU - Devroey,Dirk, AU - Velkeniers,Brigitte, AU - Duquet,William, AU - Betz,Willem, PY - 2003/09/09/received PY - 2004/01/08/revised PY - 2004/03/03/accepted PY - 2005/5/11/pubmed PY - 2005/9/15/medline PY - 2005/5/11/entrez SP - 231 EP - 5 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 101 IS - 2 N2 - BACKGROUND: Lowering high levels of low-density lipoprotein cholesterol (LDL-C) is the primary aim in the prevention of cardiac events. However, low levels of high-density lipoprotein cholesterol (HDL-C) are also associated with an increased risk of ischemic heart disease. Some patients have lower HDL-C during statin treatment than before the treatment. These patients were first described in 2002 as 'bad HDL-C responders to statins'. The aim of this study was to describe the benefit of fibrates in monotherapy for these patients. METHODS: A cross-sectional survey of lipid levels, cardiovascular disease and risk factors in outpatients treated for dyslipidemia. For this study we analyzed the lipid levels, drug treatment and medical history for 14 patients with low HDL-C (<40 mg/dl) during statin treatment and ever treated with fibrates. RESULTS: Total cholesterol (TC) and LDL-C were respectively 8% and 6% higher with fibrates compared to statins. Mean HDL-C was 49% higher during fibrate treatment and TC to HDL-C and LDL-C to HDL-C were respectively 26% and 27% lower with fibrates. CONCLUSIONS: Patients with low levels of HDL-C during statin treatment had far better levels for HDL-C, TC to HDL-C and LDL-C to HDL-C with fibrates in monotherapy. For bad HDL-C responders to statins with low or normal LDL-C treatment with fibrates instead of statins should be considered. For those with high LDL-C fibrates should be added to statins. A randomized double-blind crossover trial with simvastatin and fenofibrate has been initiated to corroborate these findings. SN - 0167-5273 UR - https://www.unboundmedicine.com/medline/citation/15882669/The_benefit_of_fibrates_in_the_treatment_of_'bad_HDL_C_responders_to_statins'_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167527304003171 DB - PRIME DP - Unbound Medicine ER -