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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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Background: Surprisingly little information on symptoms of paroxysmal atrial fibrillation is available in the scientific literature. Using questionnaires, we have analyzed the symptoms associated with arrhythmia attacks. Methods: One hundred randomly-selected patients with idiopathic paroxysmal atrial fibrillation filled in a structured questionnaire. Results: Psychic stress was the most common factor triggering arrhythmia (54%), followed by physical exertion (42%), tiredness (41%) coffee (25%) and infections (22%). Thirty-four patients cited alcohol, 26 in the form of red wine, 16 as white wine and 26 as spirits. Among these 34, red wine and spirits produced significantly more episodes of arrhythmia than white wine (p = 0.01 and 0.005 respectively). Symptoms during arrhythmia were palpitations during (88%), reduced physical ability (87%), palpitations at rest (86%), shortness of breath during exertion (70%) and anxiety (59%). Significant differences between sexes were noted regarding swollen legs (women 21%, men 6%, p = 0.027), nausea (women 36%, men 13%, p = 0.012) and anxiety (females 79%, males 51%, p =0.014). Conclusion: Psychic stress was the commonest triggering factor in hospitalized patients with paroxysmal atrial fibrillation. Red wine and spirits were more proarrhythmic than white wine. Symptoms in women in connection with attacks of arrhythmia vary somewhat from those in men.

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