Effects of Fluvastatin and Bezafibrate Combination on Plasma Fibrinogen, t-Plasminogen Activator Inhibitor and C Reactive Protein Levels in Coronary Artery Disease Patients with Mixed Hyperlipidaemia (FACT Study)

SummaryWe studied the effects of fluvastatin and bezafibrate in monotherapy and in combination on plasma fibrinogen, t-plasminogen activator inhibitor (PAI-1) and C reactive protein (CRP) in patients with coronary artery disease (CAD) and mixed hyperlipidaemiaIn this randomised, double blind, multicentre trial 333 patients with stable angina pectoris or previous myocardial infarction or coronary revascularisation and mixed hyperlipidaemia (LDL-cholesterol 135-250 mg/dl and triglycerides (TG) 180-400 mg/dl) were randomised to fluvastatin 40 mg, bezafibrate 400 mg, fluvastatin 20 mg + bezafibrate 400 mg or fluvastatin 40 mg + bezafibrate 400 mg treatments for 24 weeks.Plasma fibrinogen significantly decreased after treatment with the combinations fluvastatin+bezafibrate (−14 and −16%) and with bezafibrate monotherapy (−9%). No significant reduction was observed after fluvastatin monotherapy (−4%). No significant changes were observed in PAI-1 and CRP plasma levels. Combination therapy significantly decreased both LDL-C and TG, and significantly increased HDL-C.The combined effects on fibrinogen and plasma lipids achieved by fluvastatin and bezafibrate combination treatment might be more useful than the simple reduction of cholesterol in preventing ischaemic cardiovascular disease.

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Complement C3 and C-reactive protein levels in patients with stable coronary artery disease

Thrombosis and Haemostasis ◽

10.1160/th05-06-0384 ◽

2005 ◽

Vol 94 (11) ◽

pp. 1048-1053 ◽

Cited By ~ 41

Author(s):

Ramzi Ajjan ◽

Timothy Futers ◽

Jane Brown ◽

Charlotte Cymbalista ◽

May Boothby ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Fasting Glucose ◽

Stable Coronary Artery Disease ◽

Complement C3 ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

The Metabolic Syndrome ◽

Artery Disease

SummaryThe aim of this study was to determine whether complement C3 is an indicator of coronary artery disease (CAD). We measured plasma C3 and CRP levels in 278 patients undergoing coronary angiography for typical symptoms of CAD and 269 healthy age and sex matched controls. C3 levels were significantly higher in patients compared with controls (1.15 g/l and 0.92 g/l respectively; p<0.001). In the patient group, C3 levels correlated with BMI, fasting glucose, HbA1c, fibrinogen, CRP and HDL in both men and women. CRP levels were also higher in patients compared with controls (1.14 mg/l and 0.86 mg/l respectively; p=0.005) and correlated with markers of the metabolic syndrome. In a logistic regression model including C3, smoking, hypertension, cholesterol and diabetes, C3 was independently associated with CAD with an odds ratio of 3.20 for a 1 SD increase in C3 levels. In contrast, CRP was not independently associated with CAD in a similar regression analysis. In conclusion, both C3 and CRP plasma levels are elevated in patients with symptoms of CAD. However, C3 seems to be a better indicator of CAD than CRP in this study, suggesting that C3 could be an additional marker for risk stratification in atherosclerosis.

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Elevated C-reactive protein levels and coronary microvascular dysfunction in patients with coronary artery disease

European Heart Journal ◽

10.1093/eurheartj/ehi356 ◽

2005 ◽

Vol 26 (20) ◽

pp. 2099-2105 ◽

Cited By ~ 38

Author(s):

Fabrizio Tomai ◽

Flavio Ribichini ◽

Anna S. Ghini ◽

Valeria Ferrero ◽

Giuseppe Andò ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Microvascular Dysfunction ◽

Coronary Microvascular Dysfunction ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Artery Disease

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Plasminogen Activator Inhibitor-1 Levels in Patients with Chronic Angina Pectoris with or without Angiographic Evidence of Coronary Sclerosis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1645042 ◽

1990 ◽

Vol 63 (03) ◽

pp. 336-339 ◽

Cited By ~ 33

Author(s):

K Huber ◽

I Resch ◽

Th Stefenelli ◽

I Lang ◽

P Probst ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Angina Pectoris ◽

Plasminogen Activator ◽

Stable Coronary Artery Disease ◽

Plasminogen Activator Inhibitor ◽

Plasminogen Activator Inhibitor 1 ◽

Artery Disease ◽

Activator Inhibitor ◽

Pai 1

SummaryIncreased plasma levels of plasminogen activator inhibitor-1 (PAI-1) have been shown to exist in 40 to 60% of patients with stable coronary artery disease and have been suggested to be responsible for the development of coronary thrombotic complications. However, it is also discussed whether PAI-1 elevation might mainly be due to variables like increased age or to reactive mechanisms caused e.g. by the chest pain itself. To exclude age dependent ui pain related influences, age-matched patients with stable angina pectoris (NHYA II) and angiographically proven coronary artery disease (CAD, n = 16) or without evidence for coronary sclerosis (variant angina, n = 10; angina-like syndrome with normal coronary angiogram, n = 5; non-CAD, n = 15) have been investigated for their plasma PAI-1 activity and t-PA antigen levels. The mean PAI activity in CAD patients (17.5 U/ml) was significantly higher than in non-CAD patients (9.6 U/ml) (p <0.0001). In the CAD patients no significant variation in plasma PAI-1 values could be demonstrated when related to the extent of the disease or to a history of previous myocardial infarction t-PA antigen was also elevated m CAD patients as compared to the non-CAD group (p <0.02). The results suggest therefore a strong correlation between coronary artery disease itself and elevated levels of components of the plasma fibrinolytic system.

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