Cardiovascular events in patients received combined fibrate/statin treatment versus statin monotherapy: Acute Coronary Syndrome Israeli Surveys data.
BACKGROUND: The effect of combination of fibrate with statin on major adverse cardiovascular events (MACE) following acute coronary syndrome (ACS) hospitalization is unclear. The main aim of this study was to investigate the 30-day rate of MACE in patients who participated in the nationwide ACS Isra...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2012-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3327654?pdf=render |
| _version_ | 1818942404176117760 |
|---|---|
| author | Alexander Tenenbaum Diego Medvedofsky Enrique Z Fisman Liudmila Bubyr Shlomi Matetzky David Tanne Robert Klempfner Joseph Shemesh Ilan Goldenberg |
| author_facet | Alexander Tenenbaum Diego Medvedofsky Enrique Z Fisman Liudmila Bubyr Shlomi Matetzky David Tanne Robert Klempfner Joseph Shemesh Ilan Goldenberg |
| author_sort | Alexander Tenenbaum |
| collection | DOAJ |
| description | BACKGROUND: The effect of combination of fibrate with statin on major adverse cardiovascular events (MACE) following acute coronary syndrome (ACS) hospitalization is unclear. The main aim of this study was to investigate the 30-day rate of MACE in patients who participated in the nationwide ACS Israeli Surveys (ACSIS) and were treated on discharge with a fibrate (mainly bezafibrate) and statin combination vs. statin alone. METHODS: The study population comprised 8,982 patients from the ACSIS 2000, 2002, 2004, 2006, 2008 and 2010 enrollment waves who were alive on discharge and received statin. Of these, 8,545 (95%) received statin alone and 437 (5%) received fibrate/statin combination. MACE was defined as a composite measure of death, recurrent MI, recurrent ischemia, stent thrombosis, ischemic stroke and urgent revascularization. RESULTS: Patients from the combination group were younger (58.1±11.9 vs. 62.9±12.6 years). However, they had significantly more co-morbidities (hypertension, diabetes), current smokers and unfavorable cardio-metabolic profiles (with respect to glucose, total cholesterol, triglyceride and HDL-cholesterol). Development of MACE was recorded in 513 (6.0%) patients from the statin monotherapy group vs. 13 (3.2%) from the combination group, p = 0.01. 30-day re-hospitalization rate was significantly lower in the combination group: 68 (15.6%) vs. 1691 (19.8%) of patients, respectively; p = 0.03. Multivariable analysis identified the fibrate/statin combination as an independent predictor of reduced risk of MACE with odds ratio of 0.54, 95% confidence interval 0.32-0.94. CONCLUSION: A significantly lower risk of 30-day MACE rate was observed in patients receiving combined fibrate/statin treatment following ACS compared with statin monotherapy. However, caution should be exercised in interpreting these findings taking into consideration baseline differences between our observational study groups. |
| first_indexed | 2024-12-20T07:10:53Z |
| format | Article |
| id | doaj.art-f5ff99a8cd674ff89faca5b5857f6718 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-20T07:10:53Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-f5ff99a8cd674ff89faca5b5857f67182022-12-21T19:48:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0174e3529810.1371/journal.pone.0035298Cardiovascular events in patients received combined fibrate/statin treatment versus statin monotherapy: Acute Coronary Syndrome Israeli Surveys data.Alexander TenenbaumDiego MedvedofskyEnrique Z FismanLiudmila BubyrShlomi MatetzkyDavid TanneRobert KlempfnerJoseph ShemeshIlan GoldenbergBACKGROUND: The effect of combination of fibrate with statin on major adverse cardiovascular events (MACE) following acute coronary syndrome (ACS) hospitalization is unclear. The main aim of this study was to investigate the 30-day rate of MACE in patients who participated in the nationwide ACS Israeli Surveys (ACSIS) and were treated on discharge with a fibrate (mainly bezafibrate) and statin combination vs. statin alone. METHODS: The study population comprised 8,982 patients from the ACSIS 2000, 2002, 2004, 2006, 2008 and 2010 enrollment waves who were alive on discharge and received statin. Of these, 8,545 (95%) received statin alone and 437 (5%) received fibrate/statin combination. MACE was defined as a composite measure of death, recurrent MI, recurrent ischemia, stent thrombosis, ischemic stroke and urgent revascularization. RESULTS: Patients from the combination group were younger (58.1±11.9 vs. 62.9±12.6 years). However, they had significantly more co-morbidities (hypertension, diabetes), current smokers and unfavorable cardio-metabolic profiles (with respect to glucose, total cholesterol, triglyceride and HDL-cholesterol). Development of MACE was recorded in 513 (6.0%) patients from the statin monotherapy group vs. 13 (3.2%) from the combination group, p = 0.01. 30-day re-hospitalization rate was significantly lower in the combination group: 68 (15.6%) vs. 1691 (19.8%) of patients, respectively; p = 0.03. Multivariable analysis identified the fibrate/statin combination as an independent predictor of reduced risk of MACE with odds ratio of 0.54, 95% confidence interval 0.32-0.94. CONCLUSION: A significantly lower risk of 30-day MACE rate was observed in patients receiving combined fibrate/statin treatment following ACS compared with statin monotherapy. However, caution should be exercised in interpreting these findings taking into consideration baseline differences between our observational study groups.http://europepmc.org/articles/PMC3327654?pdf=render |
| spellingShingle | Alexander Tenenbaum Diego Medvedofsky Enrique Z Fisman Liudmila Bubyr Shlomi Matetzky David Tanne Robert Klempfner Joseph Shemesh Ilan Goldenberg Cardiovascular events in patients received combined fibrate/statin treatment versus statin monotherapy: Acute Coronary Syndrome Israeli Surveys data. PLoS ONE |
| title | Cardiovascular events in patients received combined fibrate/statin treatment versus statin monotherapy: Acute Coronary Syndrome Israeli Surveys data. |
| title_full | Cardiovascular events in patients received combined fibrate/statin treatment versus statin monotherapy: Acute Coronary Syndrome Israeli Surveys data. |
| title_fullStr | Cardiovascular events in patients received combined fibrate/statin treatment versus statin monotherapy: Acute Coronary Syndrome Israeli Surveys data. |
| title_full_unstemmed | Cardiovascular events in patients received combined fibrate/statin treatment versus statin monotherapy: Acute Coronary Syndrome Israeli Surveys data. |
| title_short | Cardiovascular events in patients received combined fibrate/statin treatment versus statin monotherapy: Acute Coronary Syndrome Israeli Surveys data. |
| title_sort | cardiovascular events in patients received combined fibrate statin treatment versus statin monotherapy acute coronary syndrome israeli surveys data |
| url | http://europepmc.org/articles/PMC3327654?pdf=render |
| work_keys_str_mv | AT alexandertenenbaum cardiovasculareventsinpatientsreceivedcombinedfibratestatintreatmentversusstatinmonotherapyacutecoronarysyndromeisraelisurveysdata AT diegomedvedofsky cardiovasculareventsinpatientsreceivedcombinedfibratestatintreatmentversusstatinmonotherapyacutecoronarysyndromeisraelisurveysdata AT enriquezfisman cardiovasculareventsinpatientsreceivedcombinedfibratestatintreatmentversusstatinmonotherapyacutecoronarysyndromeisraelisurveysdata AT liudmilabubyr cardiovasculareventsinpatientsreceivedcombinedfibratestatintreatmentversusstatinmonotherapyacutecoronarysyndromeisraelisurveysdata AT shlomimatetzky cardiovasculareventsinpatientsreceivedcombinedfibratestatintreatmentversusstatinmonotherapyacutecoronarysyndromeisraelisurveysdata AT davidtanne cardiovasculareventsinpatientsreceivedcombinedfibratestatintreatmentversusstatinmonotherapyacutecoronarysyndromeisraelisurveysdata AT robertklempfner cardiovasculareventsinpatientsreceivedcombinedfibratestatintreatmentversusstatinmonotherapyacutecoronarysyndromeisraelisurveysdata AT josephshemesh cardiovasculareventsinpatientsreceivedcombinedfibratestatintreatmentversusstatinmonotherapyacutecoronarysyndromeisraelisurveysdata AT ilangoldenberg cardiovasculareventsinpatientsreceivedcombinedfibratestatintreatmentversusstatinmonotherapyacutecoronarysyndromeisraelisurveysdata |