Fenofibrate decreases plasma fibrinogen, improves lipid profile, and reduces uricemia

Plasma fibrinogen has been found to be a major cardiovascular disease risk factor. This 2-year trial was designed to assess the effect of fenofibrate on fibrinogen and, as secondary end points, on lipid profile and uric acid in patients with dyslipidemia. Eighty subjects (40 women and 40 men) were admitted to either a control or an active group. Sixty-seven (84%) had sole hypercholesterolemia, 13 (16%) subjects had mixed dyslipidemia. The effect attributable to fenofibrate was a decrease of 15% in fibrinogen, 26% in the ratio low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (-20% low-density lipoprotein cholesterol, +10% high-density lipoprotein cholesterol), 34% in triglycerides (median), and 13% in uric acid (P <.0001 for all). Fenofibrate simultaneously affected hemostasis (by lowering fibrinogenemia) and lipid profile. Because fenofibrate has few adverse effects, it could be a fair option for patients who need polytherapy and do not tolerate resins or niacin. Its clinical efficacy should be tested in long-term studies to assess its real capacity to prevent cardiovascular events.