Fenofibrate curbs heart disease in diabetics

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Treatment with fenofibrate, a cholesterol-lowering drug, reduces the risk of heart disease in patients with type 2 diabetes and components of the metabolic syndrome, researchers report in the journal Diabetes Care.

Metabolic syndrome refers to a cluster of risk factors for diabetes and heart disease—including abdominal obesity, High Blood Pressure, high blood sugar, low levels of “good” HDL cholesterol and high triglycerides (another type of blood fat). The syndrome is typically diagnosed when a person has three or more of these conditions.

Treatment with fenofibrate cut the risk of heart disease in diabetics with abnormal cholesterol levels by 27 percent, lead investigator Dr. Russell Scott told Reuters Health. He added that 23 patients would need to be treated with the drug to prevent one case of heart disease.

Scott of Christchurch Hospital, New Zealand and colleagues note that the metabolic syndrome increases the risk of heart disease and stroke, but it’s not clear whether reduction in the risk of such events in diabetic patients with fenofibrate differs depending on what features of the syndrome are present.

To investigate further, the researchers examined data from a study of fenofibrate in almost 10,000 diabetic patients, more than 80 percent of whom met criteria for the metabolic syndrome.

Most features of the metabolic syndrome, including abdominal obesity, abnormal cholesterol levels, and High Blood Pressure increased the risk of heart disease and stroke over 5 years by at least 3 percent.

Fenofibrate significantly reduced the risk of these problems in those with low HDL cholesterol or High Blood Pressure, and the greatest such effect was the 27 percent reduction seen in participants with several cholesterol abnormalities.

“These findings,” they authors conclude, “should interest physicians considering (cholesterol)-lowering therapy for patients with diabetes.”

SOURCE: Diabetes Care, March 2009.

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