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Since the publication of the ACCORD Lipid Study, in which adding a fibrate (e.g., gemfibrozil, fenofibrate) to a statin did not improve cardiovascular outcomes in patients with diabetes (JW Cardiol Mar 14 2010), fibrates have come under closer scrutiny. Now, investigators in Australia have conducted a meta-analysis of randomized trials evaluating the effects of fibrates versus placebo on cardiovascular outcomes.
The investigators identified 18 trials including 45,058 patients. Fibrates were associated with the following:
A barely significant 10% reduction in risk for cardiovascular events (5 trials; P=0.048; 95% confidence interval, 0.82–1.00)
A 13% reduction in risk for coronary events (16 trials; P<0.0001; 95% CI, 0.81–0.93)
A nonsignificant …