Flow-mediated dilation after treatments of fixed dose combination of simvastatin and fenofibrate versus high dose rosuvastatin in hypertriglyceridemia

초록

Background and Aims: Hypertriglyceridemia (triglycerides>200mg/dl) is a major cardiovascular risk factor. We want to compare between combination of simvastatin and fenofibrate and high intensity rosuvastatin (20mg) in treatment of hypertriglyceridemia. Methods: This is a non-randomized prospective observation study. One hundred fifty four hypertriglyceridemia patients were assigned 3 groups (Group A ; rosuvastatin 20mg, B ; simvastatin 20mg + fenofibrate 145mg, C ; simvastatin 40mg + fenofibrate 145mg). The brand name of fixed dose combination is Cholib. There were significant differences of age, blood glucose, BMI and ABI between 3 groups. We checked baseline and follow up lipid profile, flow medicated dilation (FMD), pulse wave velocity (PWV), carotid intima media thickness (cIMT) and augmentation index (AIx). After 1yr, we checked above parameters again. Results: After treatment, significant decrease in triglyceride and total cholesterol in all groups. Compared with Group A (rosuvastatin 20mg), B (simvastatin 20mg + fenofibrate) and C (simvastatin 40mg + fenofibrate) showed better reduction in triglyceride (p=0.044, 0.001 respectively). And, compared with Group A, Group B and C showed improvements in HDL cholesterol (p<0.001, 0.017 respectively). In contrast, Group A is better than B and C in LDL cholesterol reduction (p=0.025) There was no difference in changes of PWV and AIx between 3 groups except ABI of Group B and C (p=0.03). However, the difference of 2 groups was very small (0.0±0.1 vs 0.1±0.1). There was no difference in changes of IMT and FMD. Conclusions: Combination treatment of simvastatin and fenofibrate was better than high intensity rosuvastatin in control of hypertriglyceridemia and improvement of HDL cholesterol.