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)

Carlos A Aguilar-Salinas; Andreia Assis-Luores-Vale; Benjamin Stockins; Hector Mario Rengifo; Jose Dondici Filho; Abrahao Afiune Neto; Lisia Marcilio Rabelo; Kerginaldo Paulo Torres; Jose Egidio Paulo de Oliveira; Carlos Alberto Machado; Eliana Reyes; Victor Saavedra; Fernando Florenzano; Ma Victoria Hernandez; Sergio Hernandez Jimenez; Erika Ramirez; Cuauhtemoc Vazquez; Saul Salinas; Ismael Hernandez; Octavio Medel; Ricardo Moreno; Paula Lugo; Ricardo Alvarado; Roopa Mehta; Victor Gutierrez; Francisco J Gomez Perez

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ORIGINAL ARTICLE

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)

Carlos A Aguilar-Salinas¹, Andreia Assis-Luores-Vale², Benjamin Stockins³, Hector Mario Rengifo⁴, Jose Dondici Filho⁵, Abrahao Afiune Neto⁶, Lisia Marcilio Rabelo⁷, Kerginaldo Paulo Torres⁸, Jose Egidio Paulo de Oliveira⁹, Carlos Alberto Machado¹⁰, Eliana Reyes¹¹, Victor Saavedra¹², Fernando Florenzano¹³, Ma Victoria Hernandez¹⁴, Sergio Hernandez Jimenez¹, Erika Ramirez¹, Cuauhtemoc Vazquez¹⁵, Saul Salinas¹⁵, Ismael Hernandez¹⁶, Octavio Medel¹⁶, Ricardo Moreno¹⁷, Paula Lugo¹⁸, Ricardo Alvarado¹⁹, Roopa Mehta¹, Victor Gutierrez²⁰, Francisco J Gomez Perez¹
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

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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