title: Bezafibrate treatment is associated with a reduced rate of re-hospitalization in smokers after acute coronary syndrome.
abstract: BACKGROUND
  Significantly increased rate of hospitalizations in current smokers is a major smoking-related problem which is associated with a heavy economic burden, whereas cardiovascular disease accounted for nearly half of hospitalizations. The effect of bezafibrate on the rate of re-hospitalization in smokers already treated with statin immediately post-acute coronary syndrome (ACS) is unknown. The aim of this study was to investigate 30-day rate of re-hospitalization in current smokers participating in the ACS Israeli Surveys (ACSIS) and who were treated on discharge with a bezafibrate/statin combination vs. statin alone.
  
  
  METHODS
  The study population comprised 3392 patients with confirmed current smoking status from the ACSIS 2000, 2002, 2004, 2006, 2008 and 2010 enrollment waves who were alive on discharge and received statin. Of these, 3189 (94%) were discharged with statin alone, 203 (6%) with a combination of a statin and bezafibrate.
  
  
  RESULTS
  Thirty-day re-hospitalization rate was significantly lower in patients from the combination group than in their counterparts from the statin monotherapy group: 12.8% vs. 19%, p = 0.028. Multivariable analysis identified the combined bezafibrate/statin treatment as an independent predictor of reduced risk of 30-day re-hospitalization rate with odds ratio (OR) 0.53 (95% confidence interval [CI] 0.31-0.91), and it corresponded to 47% risk reduction. Other significant variables in our model associated with independent risk of 30-day re-hospitalization rate during the follow-up were female gender (OR 1.43, CI 1.05-1.95, p = 0.03) and age > 65 years (OR 1.49, CI 1.13-1.95, p = 0.004).
  
  
  CONCLUSIONS
  Adding bezafibrate to statin in smokers was associated with a significantly reduced 30-day rate of re-hospitalization after ACS.
authors.forename: Robert
authors.initials: R
authors.lastname: Klempfner
authors.forename: Ilan
authors.initials: I
authors.lastname: Goldenberg
authors.forename: Enrique Z
authors.initials: EZ
authors.lastname: Fisman
authors.forename: Uri
authors.initials: U
authors.lastname: Amit
authors.forename: Alexander
authors.initials: A
authors.lastname: Haitovich
authors.forename: Shlomi
authors.initials: S
authors.lastname: Matetzky
authors.forename: Diego
authors.initials: D
authors.lastname: Medvedofsky
authors.forename: Joseph
authors.initials: J
authors.lastname: Shemesh
authors.affiliation: Cardiac Rehabilitation Institute, Sackler Faculty of Medicine, Tel-Aviv, Israel Leviev Heart Institute, Sackler Faculty of Medicine, Tel-Aviv, Israel Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Cardiovascular Diabetology Research Foundation, Holon, Israel. altenen@yahoo.com.
authors.forename: Alexander
authors.initials: A
authors.lastname: Tenenbaum
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000628:therapy*; D000328:Adult; D000368:Aged; D001629:Bezafibrate / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004359:Drug Therapy, Combination; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007557:Israel; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010359:Patient Readmission; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D001629:Bezafibrate