Abstract 13481: Early Effect of Bezafibrate on Fibrinogen Levels, Inflammatory Response and Clinical Impact, in Patients With St Elevation Acute Myocardial Infarction
Introduction: Plasma fibrinogen levels have been identified as an important risk factor for cardiovascular diseases and could have a prognostic value. Bezafibrate decreases fibrinogen levels and also the incidence of major cardiovascular events in primary prevention, but its effects in acute coronary syndrome is unknown
Hypothesis: Bezafibrate effect over statin therapy reduces fibrinogen concentrations, inflammatory response and clinical events, in patients with ST segment elevation ACS and hyperfibrinogenemia.
Methods: In a randomized clinical trial, controlled with conventional therapy. We included patients with ST elevation acute myocardial infarction (STEAMI) and with fibrinogen concentration >500 mg/dl at 72 h of evolution, were randomly assigned to bezafibrate 400 mg/day (group I n=50) or just conventional therapy (group II n=50). Serum fibrinogen, c reactive protein and cytokines were measured. Clinical end points were recurrence of angina or infarction, left ventricular failure, cardiovascular mortality and combined end points during hospitalization.
Results: Levels of Fibrinogen (462 Vs 658 mg/dl), C reactive protein (2.78 Vs 6.0mg/dl), IL-6 (median 2.83 Vs 9.57pg/ml) were significantly lower at hospital discharge in Group I (figure 1). Clinical end points were more frequent in Group II than in Group I (angina 18% Vs 2% p<0.0001, myocardial infarction 4% Vs 0% p=0.041, heart failure 9% vs 1% p= 0.008, respectively) (figure 2). After removal of the covariate influence, additive effect of Bezafibrate was associated with less angina, heart failure and combined end point.
Conclusions: The additive effect of bezafibrate over statin, significantly reduced fibrinogen levels and the inflammatory response in patients with STEAMI and hyperfibrinogenemia. In the short term, this reduction was associated with a lower incidence of major cardiovascular events
Author Disclosures: A. Madrid Miller: None. L.A. Moreno Ruiz: None. F. Solis Nuñez: None. L. Chávez Sánchez: None. G. Borrayo Sánchez: None. E. Almeida Gutiérrez: None. K. Chávez Rueda: None. F. Blanco Favela: None.
- © 2014 by American Heart Association, Inc.