Prothrombotic and lipoprotein variables in patients attending a cardiovascular risk management clinic: response to ciprofibrate or lifestyle advice

Background. Lipid lowering drugs improve survival. However, intervention st udies have focused on reducing serum total cholesterol and low density Lipo protein (LDL) concentrations and have not considered that levels of high de nsity Lipoprotein (HDL), triglycerides (TG), lipoprotein (a) and fibrinogen also predict risk and outcome. Methods. A retrospective survey of patients with primary dyslipidaemia atte nding a cardiovascular risk management clinic (set in a university hospital ) was initiated to assess the effect of ciprofibrate, a drug with the poten tial to modify all these variables. Patients who received ciprofibrate (n=7 2) were compared with 64 patients who only received Lifestyle advice. Both groups had a similar age and gender distribution. The ciprofibrate group ha d a higher cardiovascular risk load but both groups shared several other ch aracteristics. Pasting serum total cholesterol, LDL, HDL, TG, lipoprotein ( a), glucose and plasma fibrinogen concentrations were measured at baseline and after 2-4 months. Results. Ciprofibrate significantly improved total cholesterol, LDL, HDL, T G, lipoprotein (a) and fibrinogen. In contrast, lifestyle advice only signi ficantly (but less markedly) reduced serum total cholesterol and TG concent rations. Conclusions. In a clinical setting, ciprofibrate has a broad spectrum of ac tion on several predictors of vascular events. Although our study is not of a double blind randomized design it reflects the conditions in clinical pr actice. Nevertheless, this type of survey has its limitations.