Comparative study of bezafibrate and pravastatin in patients with coronary artery disease and high levels of remnant lipoprotein.
BACKGROUND
Remnant lipoproteinemia is a strong risk factor for cardiovascular (CV) diseases. This study examined which of 2 common lipid-lowering drugs (fibrates and statins) is more effective in patients with remnant lipoproteinemia and if lowering remnant lipoprotein levels can reduce CV risk.


RESULTS
Remnant lipoprotein levels were measured by an immunoseparation method (remnant-like lipoprotein particles cholesterol: RLP-C) in 274 patients with coronary artery disease and high RLP-C levels (>or=5.0 mg/dl). They were randomly assigned to receive bezafibrate (200-400 mg/day) or pravastatin (10-20 mg/day), and were prospectively followed-up for 1 year or until the occurrence of CV events. Complete follow-up data were obtained in 180 patients. RLP-C levels at 1 year of treatment were reduced more by bezafibrate than pravastatin (37% and 25% from baseline, respectively). During follow-up, bezafibrate-treated patients had 3 CV events, compared with 12 events in pravastatin-treated patients (P<0.01). In multivariate logistic regression analysis, a decrease in RLP-C level was significantly associated with a reduction in CV events after adjustment for treatment group and changes in levels of other lipids.


CONCLUSIONS
Bezafibrate therapy decreased RLP-C levels to a greater extent than pravastatin and a decrease in RLP-C level may be associated with a reduction in CV events in patients with high RLP-C levels.
Sano
Keita
K
Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Chuo, Japan.
Nakamura
Takamitsu
T
Hirano
Mitsumasa
M
Kitta
Yoshinobu
Y
Kobayashi
Tsuyoshi
T
Fujioka
Daisuke
D
Saito
Yukio
Y
Yano
Toshiaki
T
Watanabe
Kazuhiro
K
Watanabe
Yosuke
Y
Mishina
Hideto
H
Obata
Jyun-Ei
JE
Kawabata
Ken-ichi
K
Kugiyama
Kiyotaka
K
D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D001629:Bezafibrate / Q000008:administration & dosage*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000008:administration & dosage*; D014280:Triglycerides / Q000097:blood
D000924:Anticholesteremic Agents; D000960:Hypolipidemic Agents; D008055:Lipids; D008074:Lipoproteins; D014280:Triglycerides; C112017:remnant-like particle cholesterol; D002784:Cholesterol; D017035:Pravastatin; D001629:Bezafibrate