title: Analysis of the Cochrane Review: Fibrates for secondary prevention of cardiovascular disease and stroke.
abstract: The influence of fibrates on cardiovascular risk has been the focus of several clinical trials. This Cochrane Collaboration Systematic Review evaluated the efficacy of fibrates for secondary prevention of cardiovascular events and stroke, analyzing 13 randomized controlled trials, in a total of 16 112 participants with a history of cardiovascular disease. Fibrates showed a protective effect for the composite outcome of non-fatal stroke, non-fatal myocardial infarction (MI) and vascular death, mainly due to reduction in the risk of non-fatal or fatal MI. Nonetheless, these results largely relied on studies including clofibrate, a drug withdrawn from the market in 2002. No statistically significant differences regarding adverse events were found between fibrates and placebo. Although insufficient to support the routine prescription of fibrates in this setting, this evidence should be taken into account when deciding on lipid-modifying therapy in dyslipidemic patients with a history of cardiovascular disease.
authors.affiliation: Serviço de Medicina Interna, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Pires da Rosa
authors.affiliation: Serviço de Gastrenterologia, Instituto Português de Oncologia do Porto (IPO-Porto), Porto, Portugal.
authors.forename: Diogo
authors.initials: D
authors.lastname: Libânio
authors.affiliation: Center for Health Technology and Services Research (CINTESIS), Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Informação e da Decisão em Saúde (CIDES), Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Cochrane Portugal - Unidade do Porto, Porto, Portugal. Electronic address: lazevedo@med.up.pt.
authors.forename: Luís
authors.initials: L
authors.lastname: Filipe Azevedo
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control*; D058607:Fibric Acids / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D020521:Stroke / Q000517:prevention & control*
chemical_list: D058607:Fibric Acids
keywords: Acidente vascular cerebral; Cardiovascular events; Eventos cardiovasculares; Fibrates; Fibratos; Prevenção secundária; Revisão sistemática; Secondary prevention; Stroke; Systematic review