TY - JOUR
T1 - Maxepa versus bezafibrate in hyperlipidemic cardiac transplant recipients
AU - Barbir, Mahmoud
AU - Hunt, Beverley
AU - Kushwaha, Sudhir
AU - Kehely, Anne
AU - Prescot, Robin
AU - Thompson, Gilbert R.
AU - Mitchell, Andrew
AU - Yacoub, Magdi
PY - 1992/12/15
Y1 - 1992/12/15
N2 - Accelerated coronary artery disease is the most serious obstacle to long-term survival in cardiac transplant recipients. Lipid abnormalities are found frequently in these patients, and there is growing evidence that even minimally increased levels of cholesterol and triglycerides contribute to the development of accelerated coronary artery disease. However, the optimal lipid-lowering therapy after cardiac transplantation has not been defined. In an open, randomized study, the efficacy and safety of bezafibrate (400 mg/day) and fish oil (Maxepa) (10 g/day) for 3 months were compared in 87 cardiac transplant recipients with serum total cholesterol >6.5 or triglycerides >2.8 mmol/liter, or both. After 1 month, bezafibrate reduced total cholesterol by 13%, low-density lipoprotein cholesterol by 20% and apolipoprotein B by 13%. It also increased apolipoprotein A1 and high-density lipoprotein cholesterol by 12 and 20%, respectively, and significantly reduced fibrinogen at 3 months. Maxepa had no significant effect on these variables, but was as effective as bezafibrate in reducing triglycerides (36 and 31%, respectively). Both drugs increased lipoprotein (a) to a similar extent, and bezafibrate significantly increased serum creatinine. These results suggest that bezafibrate has better lipid-, apolipoprotein-and hemostatic modifying properties than does Maxepa, but its potentially adverse effect on renal function needs further investigation.
AB - Accelerated coronary artery disease is the most serious obstacle to long-term survival in cardiac transplant recipients. Lipid abnormalities are found frequently in these patients, and there is growing evidence that even minimally increased levels of cholesterol and triglycerides contribute to the development of accelerated coronary artery disease. However, the optimal lipid-lowering therapy after cardiac transplantation has not been defined. In an open, randomized study, the efficacy and safety of bezafibrate (400 mg/day) and fish oil (Maxepa) (10 g/day) for 3 months were compared in 87 cardiac transplant recipients with serum total cholesterol >6.5 or triglycerides >2.8 mmol/liter, or both. After 1 month, bezafibrate reduced total cholesterol by 13%, low-density lipoprotein cholesterol by 20% and apolipoprotein B by 13%. It also increased apolipoprotein A1 and high-density lipoprotein cholesterol by 12 and 20%, respectively, and significantly reduced fibrinogen at 3 months. Maxepa had no significant effect on these variables, but was as effective as bezafibrate in reducing triglycerides (36 and 31%, respectively). Both drugs increased lipoprotein (a) to a similar extent, and bezafibrate significantly increased serum creatinine. These results suggest that bezafibrate has better lipid-, apolipoprotein-and hemostatic modifying properties than does Maxepa, but its potentially adverse effect on renal function needs further investigation.
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U2 - 10.1016/0002-9149(92)90463-9
DO - 10.1016/0002-9149(92)90463-9
M3 - Article
C2 - 1466329
AN - SCOPUS:0027049755
SN - 0002-9149
VL - 70
SP - 1596
EP - 1601
JO - The American journal of cardiology
JF - The American journal of cardiology
IS - 20
ER -