Comparison of Fenofibrate versus Gemfibrozil in the Management of Hypertriglyceridemia in Patients with Coronary Heart Disease

Abstract

Objectives: To compare the

 mean triglyceride (TG) level with fenofibrate versus gemfibrozil in patients presenting with acute coronary syndrome. Design: Randomized controlled trial (RCT) Setting: Department of Medicine Allied Hospital, Faisalabad. Period: From August 2014 to June 2015. Methodology: A total of 100 cases (50 in each group) were included in the study. Patients were randomly divided in tow groups by using lottery method. In group-F, patients were prescribed fenofibrate capsule of 201mg/day and in group-G, patients prescribed gemfibrozil 600mg twice/day. Patients were followed for 12 weeks. Results: Mean age of the patients was 59.40±10.93 and 59.04±10.77 years in group-A and B, respectively. In group-F, 30 patients (60.0%) were male and 20 patients (40.0%) were female while in group-G, 27 patients (54.0%) were male and 23 patients (46.0%) were female. In group-F, 25 patients (50.0%) were obese and in group-G, 27 patients (54.0%) were obese. Unstable angina was observed in 27 patients (54.0%) of group-F and in 17 patients (34.0%) of group-G. NSTEMI (non ST segment elevated MI) noted in 10 patients (20.0%) of group-F and 20 patients (40.0%) of group-G while STEMI (ST segment elevated MI) was present in 13 patients (26.0%) in both groups. When comparison of triglyceride level was made, mean triglyceride level in group-F was 172.76±21.52 mg/dl and in group-G 214.12±44.09 mg/dl. Statistically significant difference was observed between two groups (p<0.001). Conclusion:  Mean triglyceride level at 12 weeks was lower in fenofibrate group as compared to gemfibrozil group. This study favorably supports the use of fenofibrate in the treatment of hypertriglyceridemia in patients presenting with acute coronary syndrome.