Fenofibrate add on to statins reduces CV risk in metabolic syndrome: BMJ

Korea: Fenofibrate given as an add-on to statin significantly reduced the risk of major cardiovascular events in people with metabolic syndrome than statin treatment alone, a recent study published in the BMJ journal has found.

According to Mayo Clinic, metabolic syndrome is a cluster of conditions that occur together increasing the risk of heart disease, type 2 diabetes and stroke. These conditions include abnormal cholesterol or triglyceride levels, excess body fat around the waist, high blood sugar and increased blood pressure.

"Fenofibrate is a peroxisome proliferator-activated receptor-α agonist that has been suggested as an important treatment option in the management of dyslipidaemia owing to its effects on hypertriglyceridaemia and low HDL cholesterol concentrations," wrote the authors.

Nam Hoon Kim, associate professor, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea, and colleagues investigated whether fenofibrate as an add-on to statin treatment reduces persistent cardiovascular risk in adults with metabolic syndrome in a real-world setting.

The study involved 29 771 adults with metabolic syndrome (≥40 years) receiving statin treatment. 2156 participants receiving combined treatment (statin plus fenofibrate) were weighted based on score in a 1:5 ratio with 8549 participants using statin only treatment.

The primary outcome was composite cardiovascular events including incident coronary heart disease, ischaemic stroke, and death from cardiovascular causes.

• The incidence rate per 1000 person-years of composite cardiovascular events was 17.7 in the combined treatment group and 22.0 in the statin group.


• The risk of composite cardiovascular events was significantly reduced in the combined treatment group compared with the statin group (adjusted hazard ratio 0.74).


• The significance was maintained in the on-treatment analysis (hazard ratio 0.63).


• The risk of incident coronary heart disease, ischaemic stroke, and cardiovascular death was lower in the combined treatment group than the statin group but was not significant.


• Participant characteristics did not appear to be associated with the low risk of composite cardiovascular events with combined treatment.

"We found a beneficial role of add-on fenofibrate to statin treatment in cardiovascular risk reduction in adults with metabolic syndrome," concluded the authors.

More Information: "Use of fenofibrate on cardiovascular outcomes in statin users with metabolic syndrome: propensity-matched cohort study" published in the BMJ journal.

DOI: https://doi.org/10.1136/bmj.l5125

Journal Information: The BMJ