Fibrates in the secondary prevention of cardiovascular disease (infarction and stroke). Results of a systematic review and meta-analysis of the Cochrane collaboration

Clin Investig Arterioscler. 2018 Jan-Feb;30(1):30-35. doi: 10.1016/j.arteri.2017.11.001. Epub 2018 Feb 1.
[Article in English, Spanish]

Abstract

Fibrates are a group of drugs that are known mainly for reducing triglycerides, increasing high density lipoproteins (HDL), and reducing the fraction of small, dense LDL particles. The results of a Cochrane Collaboration study have recently been published on their efficacy and safety in the secondary prevention of severe cardiovascular accidents, including coronary and cerebrovascular disease. The study included randomised clinical trials in which the fibrate was compared with placebo or with no treatment. Clinical trials comparing two different fibrates were excluded. The clinical trials evaluated included a total of 16,112 patients (13 trials). The meta-analysis (including all the trials with fibrates) showed evidence of a protective effect of the fibrates compared with placebo as regards a compound objective of non-fatal stroke, non-fatal myocardial infarction, and death of cardiovascular origin (hazard ration of 0.88, with a 95% confidence interval of 0.83 to 0.94; in 16,064 individuals included in 12 studies). Thus, the results showed, with a moderate level of evidence, that fibrates could be effective in secondary prevention considering a compound objective of non-fatal stroke, non-fatal myocardial infarction, and death of cardiovascular origin.

Keywords: Fibrates; Fibratos; Prevención secundaria; Review; Revisión; Secondary prevention.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Fibric Acids / adverse effects
  • Fibric Acids / therapeutic use*
  • Humans
  • Hypolipidemic Agents / adverse effects
  • Hypolipidemic Agents / therapeutic use*
  • Myocardial Infarction / etiology
  • Myocardial Infarction / prevention & control
  • Randomized Controlled Trials as Topic
  • Secondary Prevention / methods
  • Stroke / etiology
  • Stroke / prevention & control

Substances

  • Fibric Acids
  • Hypolipidemic Agents