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. 2023 Dec 28;13(1):168.
doi: 10.3390/jcm13010168.

Can Concurrent Fibrate Use Reduce Cardiovascular Risks among Moderate Chronic Kidney Disease Patients Undergoing Statin Therapy? A Cohort Study

Li-Yi Ma  1 , Pei-Chun Fan  1   2 , Chao-Yu Chen  1   2 , Yi-Ran Tu  1   2 , Ching-Chung Hsiao  2   3 , Chieh-Li Yen  1   2 , Chih-Hsiang Chang  1   2
Affiliations

Can Concurrent Fibrate Use Reduce Cardiovascular Risks among Moderate Chronic Kidney Disease Patients Undergoing Statin Therapy? A Cohort Study

Li-Yi Ma et al. J Clin Med. .

Abstract

The role of fibrates in treating hypertriglyceridemia in chronic kidney disease (CKD) patients to prevent cardiovascular disease (CVD) has been insufficiently investigated. Since statin is considered the first-line treatment for dyslipidemia in CKD patients, this study aims to evaluate the role of concurrent fibrate therapy with statins among moderate CKD patients. We recruited CKD3 patients from the Chang Gung Research Database who were receiving statin treatment but had not previously been administered ezetimibe or niacin. The participants were divided into two groups based on their use of fibrates (fibrate group) or those with triglyceride levels >200 mg/dL without fibrate treatment (non-fibrate group). The fibrate group (n = 954) only exhibited a significantly lower incidence of AMI (4.4% vs. 5.4%, HR: 0.77, 95% CI: 0.61 to 0.98). The risk of major adverse cardiovascular and cerebrovascular events (14.7% vs. 15.6%, HR: 0.91, 95% CI: 0.72 to 1.15) and all-cause mortality (5.7% vs. 6.1%, HR: 0.91, 95% CI: 0.63 to 1.30) did not significantly differ between the fibrate group and the non-fibrate group (n = 2358). In moderate CKD patients, combining fibrate therapy with statins may not offer additional cardiovascular protection compared to statin alone.

Keywords: AMI; CKD; MACCEs; TG; chronic kidney disease; fibrate; hypertriglyceridemia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Patient inclusion–exclusion flowchart.
Figure 2
Figure 2
The cumulative event rate for major adverse cardiac and cerebrovascular events in patients with and without the use of fibrate (fibrate plus statin vs. statin alone) in the IPTW-adjusted cohort. IPTW, inverse probability of treatment weighting; CI, confidence interval.
Figure 3
Figure 3
Subgroup analysis of major adverse cardiac and cerebrovascular events stratified by pre-specified baseline characteristics in the IPTW-adjusted cohort. IPTW, inverse probability of treatment weighting; HR, hazard ratio; CI, confidence interval; CKD, chronic kidney disease; LDL, low-density lipoprotein cholesterol.
Figure 4
Figure 4
The risks of major adverse cardiac and cerebrovascular events across different triglyceride and high-density lipoprotein levels in patients who did not take fibrate compared those who took fibrate (the reference category). aHR, adjusted hazard ratio; CI, confidence interval.
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References

    1. Pirillo A., Casula M., Olmastroni E., Norata G.D., Catapano A.L. Global epidemiology of dyslipidaemias. Nat. Rev. Cardiol. 2021;18:689–700. doi: 10.1038/s41569-021-00541-4. - DOI - PubMed
    1. Tenenbaum A., Klempfner R., Fisman E.Z. Hypertriglyceridemia: A too long unfairly neglected major cardiovascular risk factor. Cardiovasc. Diabetol. 2014;13:159. doi: 10.1186/s12933-014-0159-y. - DOI - PMC - PubMed
    1. Kovesdy C.P. Epidemiology of chronic kidney disease: An update 2022. Kidney Int. Suppl. 2022;12:7–11. doi: 10.1016/j.kisu.2021.11.003. - DOI - PMC - PubMed
    1. Thobani A., Jacobson T.A. Dyslipidemia in Patients with Kidney Disease. Cardiol. Clin. 2021;39:353–363. doi: 10.1016/j.ccl.2021.04.008. - DOI - PubMed
    1. Zoccali C., Vanholder R., Massy Z.A., Ortiz A., Sarafidis P., Dekker F.W., Fliser D., Fouque D., Heine G.H., Jager K.J., et al. The systemic nature of CKD. Nat. Rev. Nephrol. 2017;13:344–358. doi: 10.1038/nrneph.2017.52. - DOI - PubMed

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