+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Is combined statin and fibrate therapy indicated in the management of mixed hyperlipidemia?



Is combined statin and fibrate therapy indicated in the management of mixed hyperlipidemia?



Presse Medicale 27(15): 720-722



INSUFFICIENT PROGRESS: The treatment of hyperlipidemia leads to a reduced risk of coronary disease. This has been displayed notably since clinical trials have used statins. However, despite these treatments, a risk of coronary ischemia remains, which is not insignificant. There are several causes of this persistent risk which need to be analyzed. THE QUALITATIVE ASPECT OF LOW DENSITY LIPOPROTEINS: LDL are heterogeneous. This is displayed by a distribution of sizes varying from one subject to another. The predominance of small LDL is frequently found in coronary subjects detected during prospective or retrospective studies. The atherogenicity of small LDL can be explained by their physico-chemical characteristics. A remarkable fact is the predominance of small LDL in subjects with a mixed hyperlipidemia presenting a high risk of atherosclerosis. THE EFFECTS OF HYPOLIPIDEMIANTS: Statins greatly decrease LDL-cholesterol without changing LDL distribution according to size. Conversely, fibrates noticeably modify LDL distribution, reducing the percentage of small LDL. A PROPOSAL FOR THE TREATMENT OF SUBJECTS SUFFERING FROM MIXED HYPERLIPIDEMIA: If the concentration of LDL (reflected by LDL-cholesterol) and LDL distribution are two risk factors of atherosclerosis, hypolipidemic treatment should aim to act upon these two parameters, but no commercialized hypolipidemiant is effective enough as fas as they are both concerned. Therefore the combination of two hypolipidemiants, a statin and a fibrate, each having a predominant effect on one of the two factors, could be particularly effective in reducing coronary risk. This therapeutic association is effective on classic lipid parameters, does not entail more side effects than a monotherapy, and is not precluded by the RMO when there is a high vascular risk, which is often the case in mixed hyperlipidemia.

(PDF emailed within 1 workday: $29.90)

Accession: 046474089

Download citation: RISBibTeXText

PMID: 9767913


Related references

Comparison of combined statin-fibrate treatment to monotherapy in patients with mixed hyperlipidemia. Kardiologia Polska 60(6): 567-577, 2004

Treatment of combined hyperlipidemia: fibrate and/or statin?. Revue Medicale de Liege 54(7): 583-587, 1999

Statin-fibrate combinations in patients with combined hyperlipidemia. Atherosclerosis 155(1): 263-264, March, 2001

Safety and efficacy of long-term combined statin-fibrate administration in patients with combined hyperlipidemia. Cardiovascular Drugs & Therapy 11(SUPPL 2): 349, 1997

Better influence of statin than of fibrate on novel risk factors in combined hyperlipidemia. European Heart Journal 23(Abstract Supplement): 17, August-September, 2002

Statin and fibrate treatment of combined hyperlipidemia: the effects on some novel risk factors. Thrombosis and Haemostasis 92(5): 1129-1135, 2004

The reduction of inflammatory biomarkers by statin, fibrate, and combination therapy among diabetic patients with mixed dyslipidemia: the DIACOR (Diabetes and Combined Lipid Therapy Regimen) study. Journal of the American College of Cardiology 48(2): 396-401, 2006

Statin-fibrate combination: therapy for hyperlipidemia: a review. Current Medical Research and Opinion 19(3): 155-168, 2003

Safety and efficacy of long-term statin-fibrate combinations in patients with refractory familial combined hyperlipidemia. American Journal of Cardiology 80(5): 608-613, 1997

Efficacy and safety of combined statin-fenofibrates therapy compared with monotherapy in patients with mixed hyperlipidemia and high risk of coronary heart disease. Polski Merkuriusz Lekarski 15(85): 42-46, 2003

Safety and efficacy of fibrate-statin combination therapy compared to fibrate monotherapy in patients with dyslipidemia: a meta-analysis. Vascular Pharmacology 65-66(): 23-30, 2015

Comparison of the efficacy of simvastatin and standard fibrate therapy in the treatment of primary hypercholesterolemia and combined hyperlipidemia. Clinical Cardiology. 18(11): 621-629, 1995

Is it necessary to add fibrate to statin therapy in the management of dyslipidemia of metabolic syndrome?. International Journal of Cardiology 110(2): 276-277, 2005

Efficacy and safety of statin and fibrate combination therapy in lipid management. Diabetes & Metabolic Syndrome 6(3): 173-174, 2013

Comparative effects of statin and fibrate on nitric oxide bioactivity and matrix metalloproteinase in hyperlipidemia. International Journal of Cardiology 97(2): 239-244, 2004