Effects of fenofibrate on lipid profiles, cholesterol ester transfer activity, and in-stent intimal hyperplasia in patients after elective coronary stenting.
BACKGROUND
The association between modulation of detailed lipoprotein profiles and cholesterol ester transfer (CET) activity by peroxisome proliferator-activated receptor (PPAR)-a agonists in patients with coronary artery disease remains unclear. We assessed lipid profiles, plasma CET activity, and in-stent intimal hyperplasia after fenofibrate treatment in patients who underwent elective coronary stenting.


METHODS
Forty-three consecutive patients who underwent elective coronary stenting were randomized to the fenofibrate group (300 mg/day for 25 weeks, n = 22) or the control group (n = 21). At baseline and follow up, CET activity and lipoprotein profiles were measured, and quantitative coronary angiography was performed.


RESULTS
In the fenofibrate group, the levels of large very low-density lipoprotein cholesterol, and small low-density lipoprotein (LDL) cholesterol decreased and those of small high-density lipoprotein (HDL) cholesterol increased. Besides, CET activity decreased independent of the effect of fenofibrate on total and LDL cholesterol. The reduction of CET activity significantly correlated with the increase in LDL particle size (r = 0.47, P = 0.03) and the decrease of triglycerides in large HDL subclasses (r = 0.48, P = 0.03). Although there were no significant differences in restenosis parameters between the two groups, low CET activity significantly correlated with the inhibition of neointimal hyperplasia (r = 0.56, P = 0.01).


CONCLUSIONS
Fenofibrate inhibited CET activity and thereby improved atherogenic lipoprotein profiles, and reduced intimal hyperplasia after coronary stenting.
Miyazaki
Tetsuro
T
Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan. tetsuro@juntendo.ac.jp
Shimada
Kazunori
K
Miyauchi
Katsumi
K
Kume
Atsumi
A
Tanimoto
Kosei
K
Kiyanagi
Takashi
T
Sumiyoshi
Katsuhiko
K
Hiki
Makoto
M
Mokuno
Hiroshi
H
Okazaki
Shinya
S
Sato
Hitoshi
H
Kurata
Takeshi
T
Daida
Hiroyuki
H
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002788:Cholesterol Esters / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D054855:Drug-Eluting Stents; D005260:Female; D011345:Fenofibrate / Q000627:therapeutic use*; D006801:Humans; D006965:Hyperplasia / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D050356:Lipid Metabolism / Q000187:drug effects; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged
D002788:Cholesterol Esters; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D008055:Lipids; D011345:Fenofibrate