FIBRINOLYTIC EFFECT OF GEMFIBROZIL VERSUS PLACEBO ADMINISTRATION IN RESPONSE TO VENOUS OCCLUSION

Impact of hypertriglyceridemia on atherosclerotic vascular disease and thromboembolic events is recently emphasized by primary prevention st udies on the development of coronary artery disease. A randomized doub le-blind study was carried out with gemfibrozil (600 mg b.i.d.) versus placebo in 20 patients (12 males and 8 females, age 52 +/- 3 years, B MI 24.2 +/- 0.4) suffering from primary hypertriglyceridemia (Fredrick son's type IV). After a 4-week stabilization period in which administr ation of lipid-lowering drugs was stopped and an isocaloric diet was p rescribed, patients were randomized into two groups. Each group was tr eated for a 12 week period with gemfibrozil (10 patients) or placebo ( 10 patients) in a double-blind fashion. Every 4 weeks triglycerides, t otal cholesterol, HDL-cholesterol, blood glucose and Apolipoproteins A 1 and B were determined. At baseline and at the end of the treatment p eriod a venous occlusion test was performed in all subjects. Before an d after 10 min venous stasis were measured: t-PA antigen, PAI activity , fibrinogen, plasminogen, Factor VII and haematocrit. In the gemfibro zil-treated group a significant decrease of triglycerides and a signif icant increase of HDL-C was found. During gemfibrozil treatment a sign ificant reduction of Factor VII, fibrinogen and plasminogen levels eit her before or after venous occlusion was also observed. After 12 weeks of treatment in the gemfibrozil group the release of t-PA in response to venous occlusion was significantly higher and plasma PAI activity was significantly lower than in placebo group, suggesting a profibrino lytic effect of the drug.