Use of fibrates in the metabolic syndrome: A review

Table 2 Details of the large fibrate outcome trials in the total cohort are provided in this table

Trial	HHS	VA-HIT	BIP	FIELD	ACCORD
Drug	Gemfibrozil	Gemfibrozil	Bezafibrate	Fenofibrate	Fenofibrate
Dose	1200 mg/d	1200 mg/d	400 mg/d	200 mg/d	200 mg/d
Primary endpoint	MI (fatal and non-fatal), cardiac death	Combined incidence of nonfatal MI and death from CAD	MI (fatal and non-fatal), sudden death	CHD death, non-fatal MI	Non-fatal MI, non-fatal stroke, or CVD death
Mean follow-up (yr)	5	5	6	5	5
Patients (total)	Fibrate = 2051; placebo = 2030	Fibrate = 1264; placebo = 1267	Fibrate = 1548; placebo = 1542	Fibrate = 4895; placebo = 4900	Fibrate = 2765; placebo = 2753
Effect on Lipids (% change from baseline)	LDL-C: -10; TC: -11; TG: -43; HDL-C: +10	LDL-C: 0; TC: -4; TG: -31; HDL-C: +6	LDL-C: -6.5; TC: -4.5; TG: -21; HDL-C: +18	LDL-C: -12; TC: -11; TG: -29; HDL-C: +5	LDL-C: -19; TC: -14; TG: -22; HDL-C: +8.4
Outcomes	CHD: ↓ 34%; non-fatal MI: ↓ 37%; total mortality: No change	CHD and non-fatal MI: ↓ 22%; total mortality: ↓ 11% (NS)	Fatal and nonfatal MI and sudden death: ↓ 9% (NS); total mortality: No change	CHD and non-fatal MI: ↓ 11% (NS); total mortality: ↑ 19% (NS)	Nonfatal MI nonfatal stroke CVD death: ↓ 8% (NS); total mortality: ↓ 9 % (NS)

HHS: Helsinki Heart Study; VA-HIT: Veterans Affairs High-Density Cholesterol Intervention Trial; BIP: Bezafibrate Infarction Prevention; FIELD: Fenofibrate Intervention and Event Lowering in Diabetes; ACCORD: Action to Control Cardiovascular Risk in Diabetes; CVD: Cardiovascular disease; NS: Not significant; LDL-C: Low density lipoprotein cholesterol; TC: Total cholesterol; TG: Triglycerides; HDL-C: High density lipoprotein cholesterol; MI: Myocardial infarction; CAD: Coronary artery disease; CHD: Coronary heart disease.