Document Detail


Cardiovascular events in patients received combined fibrate/statin treatment versus statin monotherapy: Acute Coronary Syndrome Israeli Surveys data.
MedLine Citation:
PMID:  22523582     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The effect of combination of fibrate with statin on major adverse cardiovascular events (MACE) following acute coronary syndrome (ACS) hospitalization is unclear. The main aim of this study was to investigate the 30-day rate of MACE in patients who participated in the nationwide ACS Israeli Surveys (ACSIS) and were treated on discharge with a fibrate (mainly bezafibrate) and statin combination vs. statin alone.
METHODS: The study population comprised 8,982 patients from the ACSIS 2000, 2002, 2004, 2006, 2008 and 2010 enrollment waves who were alive on discharge and received statin. Of these, 8,545 (95%) received statin alone and 437 (5%) received fibrate/statin combination. MACE was defined as a composite measure of death, recurrent MI, recurrent ischemia, stent thrombosis, ischemic stroke and urgent revascularization.
RESULTS: Patients from the combination group were younger (58.1±11.9 vs. 62.9±12.6 years). However, they had significantly more co-morbidities (hypertension, diabetes), current smokers and unfavorable cardio-metabolic profiles (with respect to glucose, total cholesterol, triglyceride and HDL-cholesterol). Development of MACE was recorded in 513 (6.0%) patients from the statin monotherapy group vs. 13 (3.2%) from the combination group, p = 0.01. 30-day re-hospitalization rate was significantly lower in the combination group: 68 (15.6%) vs. 1691 (19.8%) of patients, respectively; p = 0.03. Multivariable analysis identified the fibrate/statin combination as an independent predictor of reduced risk of MACE with odds ratio of 0.54, 95% confidence interval 0.32-0.94.
CONCLUSION: A significantly lower risk of 30-day MACE rate was observed in patients receiving combined fibrate/statin treatment following ACS compared with statin monotherapy. However, caution should be exercised in interpreting these findings taking into consideration baseline differences between our observational study groups.
Authors:
Alexander Tenenbaum; Diego Medvedofsky; Enrique Z Fisman; Liudmila Bubyr; Shlomi Matetzky; David Tanne; Robert Klempfner; Joseph Shemesh; Ilan Goldenberg
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2012-04-16
Journal Detail:
Title:  PloS one     Volume:  7     ISSN:  1932-6203     ISO Abbreviation:  PLoS ONE     Publication Date:  2012  
Date Detail:
Created Date:  2012-04-23     Completed Date:  2012-08-03     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  101285081     Medline TA:  PLoS One     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e35298     Citation Subset:  IM    
Affiliation:
Cardiac Rehabilitation Institute, The Chaim Sheba Medical Center, Tel-Hashomer, Israel. altenen@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / complications*,  drug therapy
Cardiovascular Diseases / etiology*,  mortality
Comorbidity
Fibric Acids / administration & dosage*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
Kaplan-Meier Estimate
Middle Aged
Patient Readmission
Prospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fibric Acids; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors
Comments/Corrections

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