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Year : 2004  |  Volume : 5  |  Issue : 3  |  Page : 47-53

Ciprofibrate Therapy in Patients with Hypertriglyceridemia and Low High Density Lipoprotein (HDL)-Cholesterol: Greater Reduction of Non-HDL Cholesterol in Subjects with Excess Body Weight (The Ciproamlat Study)

1 Departamento de Endocrinologia y Metabolismo, Instituto Nacional de la Nutrición, México City, Mexico
2 Hospital Socor. Department de Aterosclerose, Rua Tupis, 1540 - 1° andar - Barro Preto - Belo Horizonte/MG-30190-062, Brazil
3 Universidad De La Frontera, Departamento Medicina Interna, Av. Francisco Salazar 01145 Temuco-Chile
4 Centro Médico del Pacífico, Departamento de Endocrinología, Calle 5B No. 42-16, Cali - Colombia
5 CINDI - Centro de Investigações Diagnósticas Ltda. Dept° de Cardiologia, Rua Rei Alberto, 196 - Centro - Juiz de Fora/MG - 36016-300, Brazil
6 Hospital São Salvador, Dept° de Cardiologia. Avenida A, 333 - Setor Oeste - Goiânia/GO - 74110-020, Brazil
7 Fundação Baiana de Cardiologia, Dept° de Lípides, Rua Augusto Viana, S/N° - Canela - Salvador/BA - 40140-060, Brazil
8 Prócardio, Dept° de Aterosclerose, Avenida Nascimento de Castro, 1930 - Lagoa Nova - Natal/RN - 59056-450, Brazil
9 Hospital Universitário Clementino Fraga Filho, Dept° de Diabetes/Nutrição, Avenida Brigadeiro Trompowiski, S/N° - Ilha do Fundão - Rio de Janeiro/RJ - 21941-590, Brazil
10 Centro de Referência de Hipertensão Arterial Diabetes e Apoio à Saúde do Idoso Dept° de Centro de Referência em Dislipidemia Rua Doutor Clementino, 200 - Belém - São Paulo/SP - 03059-030, Brazil
11 Hospital Dipreca, Unidad de Asistencia Nutricional Intensiva, División Medicina Interna Vital Apoquindo 1200, Las Condes.Santiago, Chile
12 Consulta Privada, Guardia Vieja 181 of 405, Providencia, Santiago, Chile
13 Hospital Del Salvador, Sección Cardiología, Av. Salvador 364, Providencia, Santiago, Chile
14 Hospital Fuerza Aérea De Chile, Unidad De Cardiología.Av, Las Condes 8631, Las Condes Santiago, Chile
15 Hospital de Cardiología del Centro Médico Nacional Siglo XXI (IMSS),Depto. de Estudios Metabólicos y Clínica de Lípidos.Av, Cuauhtemoc No. 330 Col Doctores.México, D. F.
16 Hospital Juárez de México (SSA).Unidad Coronaria.Av. Instituto Politécnico Nacional 5160 Col Magdalena de las Salinas.México, D. F
17 Hospital General Regional No. 72 (IMSS).Terapia Intensiva.Filiberto Gómez S/N y Vía Gustavo Baz.Tlalnepantla, Edo. de México, Mexico
18 Centro Médico Nacional de Occidente (IMSS).Departamento de Cardiología.Belisario Domínguez sin número Col. Centro.Guadalajara, Jal, Mexico
19 Hospital Dr. Santiago Ramón y Cajal (ISSSTE). Departamento de Cardiología Predio Canoa S/N Col. Los Angeles. Durango, Dgo, Mexico
20 Asociación De Diabéticos De Chile, Quebec 496, Santiago, Chile

Correspondence Address:
Carlos A Aguilar-Salinas
Departamento de Endocrinologia y Metabolismo, Instituto Nacional de la Nutrición, México City, Mexico

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Source of Support: None, Conflict of Interest: None

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Background: Hypertriglyceridemia, in combination with low HDL cholesterol levels, is a risk factor for cardiovascular disease. Our objective was to evaluate the efficacy of ciprofibrate for the treatment of this form of dyslipidemia and to identify factors associated with better treatment response. Methods: Multicenter, international, open-label study. Four hundred and thirty seven patients were included. The plasma lipid levels at inclusion were fasting triglyceride concentrations between 1.6 - 3.9 mM/L and HDL cholesterol ?1.05 mM/L for women and ?0.9 mM/L for men. The LDL cholesterol was below 4.2 mM/L. All patients received ciprofibrate 100 mg/d. Efficacy and safety parameters were assessed at baseline and at the end of the treatment. The primary efficacy parameter of the study was percentage change in triglycerides from baseline. Results: After 4 months, plasma triglyceride concentrations were decreased by 44% (p <0.001). HDL cholesterol concentrations were increased by 10% (p < 0.001). Non-HDL cholesterol was decreased by 19%. A greater HDL cholesterol response was observed in lean patients (body mass index <25 kg/m2) compared to the rest of the population (8.2 vs 19.7%, p <0.001). In contrast, cases with excess body weight had a larger decrease in non-HDL cholesterol levels (-20.8 vs -10.8%, p <0.001). There were no significant complications resulting from treatment with ciprofibrate. Conclusions: Ciprofibrate is efficacious for the correction of hypertriglyceridemia/low HDL cholesterol. A greater decrease in non-HDL cholesterol was found among cases with excess body weight. The mechanism of action of ciprofibrate may be influenced by the pathophysiology of the disorder being treated.

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