Abstract
Plasma fibrinogen is an independent risk factor of atherosclerosis. By altering lipid and plasma fibrinogen concentrations, bezafibrate modifies several factors which potentially affect progression of atherosclerosis. 23 male patients were randomized after successful PTCA. The bezafibrate group (n=11), in addition to diet, was given 200 mg bezafibrate three times daily. In the control group (n=12) there was usual care only. All patients received acetylsalicylic acid. Reassessment was after 6 months. Bezafibrate patients had a significant reduction of plasma fibrinogen from 340 ± 92 to 224 ± 29 mg/dl (p<0.05). The difference in fibrinogen concentrations within the 6 months was also significant when the two groups were compared (p<0.05). Patients of the bezafibrate group had a significant decrease of plasma triglycerides from 297 ± 303 to 134 ± 64 mg/dl (p<0.05) and a significant increase in HDL-cholesterol (30 ± 13 to 48 ± 11 mg/dl, p<0.05), apolipoproteins A1 (116 ± 19 to 138 ± 18 mg/dl, p<0.05) and apolipoproteins A2 (41 ± 8 to 56 ± 7 mg/dl, p<0.05). Changes in HDL-cholesterol and apolipoproteins A1 and A2 were also significant (p<0.05) when the two groups were compared after 6 months. Restenoses were found in 11 of the 23 patients (47.8%), 4 restenoses in the 11 bezafibrate patients and 7 restenoses in the 12 usual care patients. A potential efficacy of bezafibrate in the prevention of restenosis may be related to the drug's effects on plasma fibrinogen.
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