Fenofibrate cardioprotective, cuts risk of death in T2D

In patients with type 2 diabetes (T2D), treatment with fenofibrate appears to lower the incidence of cardiovascular events, as well as the rate of total and cardiac mortality, according to data from a large study.

The analysis used data from the South Korean National Health Insurance Service and included 63,727 patients with T2D aged 40–79 years. Of the patients, 5,057 used fenofibrate only. This group was matched to 5,057 individuals who used neither fenofibrate nor omega-3 fatty acid (control) using propensity score.

Over a median follow-up of 3 years, the primary endpoint of a composite of myocardial infarction, stroke, percutaneous coronary revascularization, and cardiac death occurred with significantly lower frequency among fenofibrate users than among controls (13.4 vs 15.5 per 1,000 person-years; hazard ratio [HR], 0.76, 95 percent confidence interval [CI], 0.62–0.94; p=0.010).

Fenofibrate use was also associated with meaningful reductions in the incidence of cardiac death (1.8 vs 3.1 per 1,000 person-years; HR, 0.59, 95 percent CI 0.352–0.987; p=0.0446), all-cause death (7.6 vs 15.3 per 1,000 person-years; HR, 0.437, 95 percent CI, 0.340–0.562; p<0.0001), and stroke (6.5 vs 8.6 per 1,000 person-years; HR, 0.621, 95 percent CI, 0.463–0.833; p=0.0015).

In an analysis stratified by the duration of fenofibrate use, the benefit was most pronounced in the group of patients who used the drug the longest (quartile 4 vs 1: HR, 0.347, 95 percent CI, 0.226–0.532; p<0.0001). The favourable effect of fenofibrate on all outcomes was consistent across subgroups defined by low- and high-density lipoprotein cholesterol and triglyceride levels.