Use of fenofibrate on cardiovascular outcomes in statin users with metabolic syndrome: Propensity matched cohort study

Nam Hoon Kim, Ki Hoon Han, Jimi Choi, Juneyoung Lee, Sin Gon Kim

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    Abstract

    To investigate whether fenofibrate as add-on to statin treatment reduce persistent cardiovascular risk in adults with metabolic syndrome in a real world setting. Design Propensity matched cohort study. Setting Population based cohort in Korea. Participants 29 771 adults with metabolic syndrome (≥40 years) receiving statin treatment. 2156 participants receiving combined treatment (statin plus fenofibrate) were weighted based on propensity score in a 1:5 ratio with 8549 participants using statin only treatment. Main outcome measure Primary outcome was composite cardiovascular events including incident coronary heart disease, ischaemic stroke, and death from cardiovascular causes. Results The incidence rate per 1000 person years of composite cardiovascular events was 17.7 (95% confidence interval 14.4 to 21.8) in the combined treatment group and 22.0 (20.1 to 24.1) in the statin group. The risk of composite cardiovascular events was significantly reduced in the combined treatment group compared with statin group (adjusted hazard ratio 0.74, 95% confidence interval 0.58 to 0.93; P=0.01). The significance was maintained in the on-treatment analysis (hazard ratio 0.63, 95% confidence interval 0.44 to 0.92; P=0.02). The risk of incident coronary heart disease, ischaemic stroke, and cardiovascular death was lower in the combined treatment group than statin group but was not significant. Participant characteristics did not appear to be associated with the low risk of composite cardiovascular events with combined treatment. Conclusion In this propensity weighted cohort study of adults with metabolic syndrome, the risk of major cardiovascular events was significantly lower with fenofibrate as add-on to statin treatment than with statin treatment alone.

    Original languageEnglish
    Article numberl5125
    JournalThe BMJ
    Volume366
    DOIs
    Publication statusPublished - 2019

    Bibliographical note

    Funding Information:
    Funding: This study was supported by the Abbott Laboratories Korea. The funders had no role in the design and conduct of the study; analysis, preparation, review, and approval of the manuscript.

    Publisher Copyright:
    © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to.

    ASJC Scopus subject areas

    • Medicine(all)

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