Analysis of the results of the ACCORD Lipid study. The positive effect of combined therapy of statin and fenofibrate in patients with type 2 diabetes mellitus

Abstract

In this article analyzed the results of the ACCORD Lipid study, a fragment of a major ACCORD study (Action to Control Cardiovascular Risk in Diabetes), which first evaluated the clinical efficacy of combination therapy with statin and fibrate in patients with type 2 diabetes and a high risk of cardiovascular disease, compared with monotherapy. Of greatest interest in this study were the results obtained in a subgroup of patients with initially high triglycerides (TG) (≥2.30 mmol/L) and low-density lipoprotein cholesterol (HDL-C) (≤0.88 mmol/L), where it was determined a significant decrease in the frequency of the onset of the primary endpoint, and was 12.4% when treated with fenofibrate versus 17.3% in the control group, while in all other participants 10.11% versus 10.11%, respectively (p = 0.057), not had differences. Summary: The addition of fenofibrate to simvastatin in patients with diabetes mellitus with high cardiovascular risk did not lead to a decrease in cardiovascular morbidity and mortality in the general population of patients. However, a reduction in the primary endpoint was achieved, in the analysis of a group of patients with high TG and low HDL-C, a significant reduction in the relative cardiovascular risk by 31% compared with the simvastatin monotherapy group was observed in the combination therapy group for simvastatin and fenofibrate.