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INTERNATIONAL ANGIOLOGY

Rivista di Angiologia


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 1998 December;17(4):225-33

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Prothrombotic and lipoprotein variables in patients attending a cardiovascular risk management clinic: response to ciprofibrate or lifestyle advice

Mikhailidis D. P., Ganotakis E. S., Spyropoulos K. A., Jagroop J. A., Byrne D. J., Winder A. F.

From the Department of Chemical Pathology & Human Metabolism Royal Free Hospital and School of Medicine, University of London, London, United Kingdom


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Background. Lipid low­er­ing drugs ­improve sur­vi­val. However, inter­ven­tion stud­ies have ­focused on reduc­ing serum total cho­les­te­rol and low den­sity lip­o­pro­tein (LDL) con­cen­tra­tions and have not con­sid­ered that lev­els of high den­sity lip­o­pro­tein (HDL), tri­gly­ce­rides (TG), lip­o­pro­tein (a) and fibrino­gen also pre­dict risk and out­come.
Methods. A ret­ro­spec­tive sur­vey of ­patients with pri­mary dys­lip­i­dae­mia attend­ing a car­di­o­vas­cu­lar risk man­age­ment clin­ic (set in a uni­ver­sity hos­pi­tal) was initiat­ed to ­assess the ­effect of ciprof­i­brate, a drug with the poten­tial to mod­i­fy all these var­i­ables. Patients who ­received ciprof­i­brate (n=72) were com­pared with 64 ­patients who only ­received life­style ­advice. Both ­groups had a sim­i­lar age and gen­der dis­tri­bu­tion. The ciprof­i­brate group had a high­er car­di­o­vas­cu­lar risk load but both ­groups ­shared sev­er­al other char­ac­ter­is­tics. Fasting serum total cho­les­te­rol, LDL, HDL, TG, lip­o­pro­tein (a), glu­cose and plas­ma fibrino­gen con­cen­tra­tions were meas­ured at base­line and after 2-4 ­months.
Results. Ciprofibrate sig­nif­i­cant­ly ­improved total cho­les­te­rol, LDL, HDL, TG, lip­o­pro­tein (a) and fibrino­gen. In con­trast, life­style ­advice only signi­fi­cant­ly (but less mark­ed­ly) ­reduced serum total cho­les­te­rol and TG con­cen­tra­tions.
Conclusions. In a clin­i­cal set­ting, ciprof­i­brate has a broad spec­trum of ­action on sev­er­al pre­dic­tors of vas­cu­lar ­events. Although our study is not of a dou­ble blind ran­dom­ized ­design it ­reflects the con­di­tions in clin­i­cal prac­tice. Nevertheless, this type of sur­vey has its lim­i­ta­tions.

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