Rheological effects of gemfibrozil in occlusive arterial disease

Abstract

Despite the extensive research demonstrating the benefits of lipid lowering therapy in occlusive arterial disease, there is a paucity of data on the rheological effects of such treatment. We have investigated the rheological effects of gemfibrozil in 50 patients with angiographically documented but stable peripheral occlusive arterial disease. Serum lipids, plasma fibrinogen, whole blood viscosity, plasma viscosity, red cell aggregability and red cell deformability were measured on two baseline samples, separated by 2 weeks of treatment with placebo, and compared with the results obtained after 12 weeks of gemfibrozil (Lopid) 600mg b.d.

Treatment with gemfibrozil resulted in a significant reduction in mean serum cholesterol (6.42 mmol/l to 5.62 mmol/l; p<0.01) and triglyceride values (2.25 mmol/l to 1.61 mmol/l; p=0.02) coupled with a decrease in haematocrit (45.4% to 44.6%; p<0.01) but an overall increase in plasma fibrinogen (3.42 to 3.88 g/l; p<0.01). The net effects of gemfibrozil were to increase mean plasma viscosity, reduce red cell deformability and aggregation and leave native whole blood viscosity unchanged. The changes in fibrinogen and plasma viscosity are of particular concern and have not been previously documented.