Abstract
Objective: To evaluate the triglyceride-lowering effect and safety of pemafibrate in secondary prevention of coronary artery disease (CAD).
Patients and methods: Forty-six patients (male, n = 38; female, n = 8; mean age, 68 years) with CAD and a triglyceride (TG) concentration of 150 mg/dl or higher according to an ambulatory blood draw were included. Other coronary risk factors included diabetes mellitus in 24 patients (52%) and hypertension in 36 patients (78%). Forty-four patients had undergone previous coronary revascularization procedures, 86% by percutaneous coronary intervention (PCI) and 14% by coronary artery bypass grafting (CABG). All patients were taking statins. All patients were ambulatory, and blood was drawn before the administration of pemafibrate and at approximately 3, 6, 12, and 24 months after the initiation of pemafibrate treatment. Blood samples were obtained in a nonfasting state, 2–4 hours after breakfast.
Results: In comparison to previous values, TG levels were significantly lower at all time points, with similar reductions up to 24 months (pretreatment, 223 mg/dl; 3 months, 136 mg/dl; 6 months, 117 mg/dl; 12 months, 131 mg/dl, and 24 months, 124 mg/dl). Mildly elevated low-density lipoprotein cholesterol levels were observed in the early stages of pemafibrate treatment, and statin use increased or ezetimibe was added to 15 patients. Significant increases in high-density lipoprotein cholesterol levels were observed at 3 and 6 months. There were no significant changes in the estimated glomerular filtration rate, aspartate aminotransferase or alanine aminotransferase levels during the treatment period.
Conclusions: Pemafibrate effectively reduced TG levels for up to 2 years, without side effects, in patients with a history of PCI or CABG.
