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The role of fibrates in current dyslipidemia therapy

Publication at Faculty of Medicine in Pilsen |
2015

Abstract

Dyslipidemias belong to the most common metabolic disorders. The first approach in dyslipidemia management is life style modification (i.e. non-smoking, rational diet, regular physical activity etc.).

The primary aim of dyslipidemia pharmacotherapy is LDL-cholesterol (standard risk factor of atherosclerosis) reduction (according to the patient's global cardiovascular risk). The secondary aim should be to influence the other lipids, especially atherogenic dyslipidemia (increased triglycerides and/ or reduced HDL-cholesterol).

Non-HDL-cholesterol or apolipoprotein B represent the aims of the successful treatment of atherogenic dyslipidemia, again according to the patient's global cardiovascular risk. High risk of atherosclerosis is mediated in patients with atherogenic dyslipidemia by small dense LDL particles and by remnant cholesterol, which is located in the remnants of triglyceride-rich lipoproteins.

Fibrates are more successful in the treatment of atherogenic dyslipidemia than statins; fenofibrate is the most common fibrate used in our country. The fixed combination of simvastatin and fenofibrate is considered by experts in lipidology to be very safe and useful in patients with (very) high cardiovascular risk and with atherogenic dyslipidemia, which is frequent concurrently with m etabolic syndrome and/or type 2 diabetes mellitus.