title: Comparative study of bezafibrate and pravastatin in patients with coronary artery disease and high levels of remnant lipoprotein.
abstract: 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.
authors.affiliation: Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Chuo, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Sano
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Nakamura
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hirano
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kitta
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fujioka
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saito
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yano
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Hideto
authors.initials: H
authors.lastname: Mishina
authors.forename: Jyun-Ei
authors.initials: JE
authors.lastname: Obata
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Kawabata
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kugiyama
mesh_terms: 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
chemical_list: D000924:Anticholesteremic Agents; D000960:Hypolipidemic Agents; D008055:Lipids; D008074:Lipoproteins; D014280:Triglycerides; C112017:remnant-like particle cholesterol; D002784:Cholesterol; D017035:Pravastatin; D001629:Bezafibrate