Bezafibrate May Reduce Heart Attack Risk
Patients with the metabolic syndrome have a high risk of myocardial infarction (MI). Could bezafibrate (e.g., Bezalip®, Roche), a derivative of fibric acid, be helpful?
Researchers from Israel studied 1,470 patients with at least three risk factors for the syndrome: a fasting glucose level of 110 mg/dl; a triglyceride level of 150 mg/dl; a high-density lipoprotein-cholesterol level below 40 mg/dl in men and less than 50 mg/dl in women; a systolic blood pressure of 130 mm Hg or a diastolic pressure of 85 mm Hg; and overweight (a body mass index of 28 kg/m2).
Of these patients, 193 had experienced a new MI. Bezafibrate was associated with a reduced risk of any MI, nonfatal MIs, and cardiac mortality. The decreased risk was “remarkably” strengthened in 575 patients with four to five risk factors, the researchers say.
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Fibrates, with their glucose-lowering properties, appeared to target therapeutic goals more selectively in obese patients with insulin resistance and the metabolic syndrome, the researchers said.
In smaller studies, bezafibrate slowed the progression of coronary atherosclerosis and reduced the rate of coronary events. In a trial of 1,568 men with lower-extremity arterial disease, beza-fibrate reduced the severity of intermittent claudication and the incidence of nonfatal coronary events, particularly in patients older than 65 years of age.
