New analysis to guide better treatment of heart disease: Heart benefit found for fibrates

A new systematic review has provided much needed clarity for clinicians across the world, confirming the benefits of cholesterol medication, for patients at high risk of heart disease. The analysis, undertaken at The George Institute, showed that fibrates, a commonly used medication used to improve cholesterol and prevent heart disease, provide a 10-15% reduced risk of serious cardiovascular events, mainly due to a reduction in the risk of heart attack.

“A number of previous trials have reported inconsistent findings regarding the effect of fibrates on cardiovascular risk. This has caused a fair bit of uncertainty among clinicians, and is the reason why we conducted this large scale systematic review”, said Associate Professor Vlado Perkovic, The George Institute.

Researchers assessed more than 45,600 patients involved in 18 randomised controlled trials conducted between 1950 and March 2010. The paper, fast-tracked and published in today’s Lancet says that “combining the data from multiple studies has provided the statistical power to detect the likely real effects of fibrates.”

While statins are widely used to lower LDL cholesterol and substantially reduce the risk of heart attack, the authors note that a high residual risk of heart disease remains. These new data indicate that fibrates, which reduce triglyceride levels and raise HDL cholesterol, can provide further protection.  While the effects are not as large as those achieved with statins, they are nonetheless important.

“Among high risk patients treated with fibrates, one event would be prevented amongst every 50 patients treated for five years. These are important findings as cardiovascular disease continues to be the leading cause of death and disability in the world”, added Dr Perkovic.

“With modern fibrates being safe and well tolerated these agents appear to have a role in cardiac protection,” he added.