Prevention & lipidsMeta-analysis
The effect of fibrates on lowering low-density lipoprotein cholesterol and cardiovascular risk reduction: a systemic review and meta-analysis
- Systematic review and meta-analysis of randomised trials
- prespecified meta-regression
Authors' conclusion
Treatment with fibrates was associated with decreased risk of MACE. The reduction in MACE risk with fibrate therapy appears to be attributable to LDL-C reduction rather than a decrease in triglyceride levels.
Study context
- Population
- RCTs of fibrate therapy vs placebo reporting CV outcomes and lipid profile changes12 trials
- Participants
- 25,781 vs 27,450
- Comparison
- Fibrates vs placebo
- Fibraten = 25,781
- Controln = 27,450reference
- Outcome
- Outcome of each trial most closely corresponding to MACE:
- CV death
- Acute MI
- Stroke
- Coronary revascularization
Pooled result
MACE
Relative risk
0.87
95% CI 0.81–0.94
Events by group
Fibrate
2741
events
Control
3754
events
Fibrate vs Control
RR 0.87 (95% CI 0.81–0.94)
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| MACE per 1 mmol/L LDL-C reduction (meta-regression) · per 1 mmol/L LDL-C reduction | 0.71 (0.49–0.94) | P = 0.01 | |
| MACE per 1 mmol/L TG reduction (meta-regression) · per 1mmol/L TG reduction | 0.96 (0.53–1.40) | P = 0.86 | |
| 0.512Relative risk (log scale) |
CV death or acute MI (sensitivity analysis)
- Similar results
Original publication
The effect of fibrates on lowering low-density lipoprotein cholesterol and cardiovascular risk reduction: a systemic review and meta-analysis. Eur J Prev Cardiol. Published 19 October 2023. doi:10.1093/eurjpc/zwad331
Summarised from the published abstract; every number is checked against it