Reference : Belgian expert opinion: how to reduce the residual risk in atherogenic dyslipidaemic ...
Scientific journals : Article
Human health sciences : Pharmacy, pharmacology & toxicology
Human health sciences : Endocrinology, metabolism & nutrition
Belgian expert opinion: how to reduce the residual risk in atherogenic dyslipidaemic patients: place of fibrates.
Ducobu, Jean [> > > >]
Scheen, André mailto [Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale >]
Van Gaal, Luc [> > > >]
Velkeniers, Brigitte [> > > >]
Hermans, Michel [UCL]
Acta Cardiologica
Acta Medica Belgica
Yes (verified by ORBi)
[en] Antilipemic Agents/therapeutic use ; Atherosclerosis/epidemiology/etiology/prevention & control ; Belgium/epidemiology ; Clofibric Acid/therapeutic use ; Dyslipidemias/complications/drug therapy/epidemiology ; Humans ; Morbidity ; Risk Factors
[en] The demographics of dyslipidaemia have changed towards a more complex atherogenic dyslipidaemia involving increased levels of LDL-C, in particular highly atherogenic small dense particles, hypertriglyceridaemia and low HDL, together with increased levels of markers of cardiovascular inflammation, thrombogenesis and endothelial dysfunction. Statins were shown to significantly lower cardiovascular morbidity and mortality, but there still remains a high residual risk in dyslipidaemic patients, in particular with metabolic syndrome, type 2 diabetes, or low HDL levels. Fibrates have been shown to reduce plasma triglycerides and increase HDL-C, while improving inflammation, thrombogenesis and endothelial dysfunction. Clinical trials with fibrates have demonstrated their potential to reduce cardiovascular morbidity and mortality too, often through other mechanisms than these of statins. Combination trials of statins with fibrates have shown a more complete improvement of lipid profile and risk markers than each class separately. In contrast with gemfibrozil, fenofibrate does not interact significantly with the pharmacokinetics of statins, and up to now its combination with statins has been shown to have a low risk of muscular side effects or liver toxicity. The ACCORD outcome trial is exploring the possible benefits of the combination of fenofibrate with statins on morbidity and mortality of patients with atherogenic dyslipidaemia.
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