Fibrate Therapy: Impact on Dyslipidemia and Cardiovascular Events in Diabetic Patients

  • Eliot A. Brinton
Part of the Contemporary Diabetes book series (CDI)


Coronary heart disease (CHD) and ischemic stroke are both primarily due to atherosclerosis. Due to their common pathophysiology, they are often considered together under the term of cardiovascular disease (CVD). CVD is the leading cause of morbidity and mortality in the United States [1], with over three-quarters of a million new cases of CHD and a similar number of strokes each year. Lowering of levels of low-density lipoprotein-cholesterol (LDL-C) with statin monotherapy is well proven to reduce CVD events by about 20–50 % [2]. Importantly, the degree of risk reduction is proportional to the degree of LDL-C decrease—21 % CVD event decrease per 39 mg/dL (1 mmol/L) LDL-C decrease [2]—and an identical 21 % decrease per 39 mg/dL decrease is seen in patients with diabetes mellitus type 2 (DM-2) [3]. Due to higher overall CVD risk in DM-2 (other risk factors being equal), the absolute risk reduction is greater than in those without DM-2, and only 24 patients with DM-2 would need a statin-induced 39 mg/dL decrease in LDL-C for 5 years to prevent one major CVD event. Although such treatment is clinically useful and generally cost-effective, it is important to note that the majority of CVD events, roughly 50–80 %, still occur despite statin treatment [4–7]. Of course, there is considerable interest in learning how to reduce this large residual risk. This is especially true in patients with high CVD risk due to strong risk factors such as DM-2, among whom the 50–80 % residual CVD risk is thus larger in absolute terms.


Cholesteryl Ester Transfer Protein Lecithin Cholesterol Acyl Transferase Statin Monotherapy Fibrate Therapy Fibrate Treatment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Cardiovascular GeneticsUniversity of Utah School of MedicineSalt Lake CityUSA
  2. 2.Utah Lipid CenterSalt Lake CityUSA
  3. 3.Utah Foundation for Biomedical ResearchSalt Lake CityUSA

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