The Risk of Ischaemic Stroke during the Fluvastatine and Fenofibrate Treatment

Česká verzia

Authors: D. Školoudík ¹; M. Bar ¹; D. Václavík ²; O. Škoda ³; J. Korsa ⁴; P. Hradílek ¹; K. Šimíčková ¹; V. Kosek ⁵; V. Ploticová ⁶; K. Urbancová ⁷; R. Herzig ⁸; P. Kaňovský ⁸
Authors place of work: Neurologická klinika ¹; Neurologické oddělení ²; Neurologické oddělení, Nemocnice Pelhřimov ³; Neurologická klinika, FN Královské Vinohrady, Praha ⁴; Oddělení informatiky ⁵; Lipologická ambulance, FNsP Ostrava-Poruba, Ostrava ⁶; Lipologická ambulance, Vítkovická nemocnice, Ostrava ⁷; Neurologická klinika, FN a LF, Olomouc ⁸
Published in the journal: Cesk Slov Neurol N 2007; 70/103(2): 163-167
Category: Original Paper

Summary

Introduction:
A neurological ultrasound study is an open, randomized multicentric trial realized in 4 neurosonological centres in the Czech Republic. A secondary aim of the study was to find out differences in the number of vascular accidents occurring in the course of therapy with fluvastatine and phenofibrate.

Methods:
Totally 376 patients with neurological symptoms, atherosclerotic plate in the carotid bifurcation over 2.0 mm (mean 3.05 mm) and the total level of cholesterol over 5.0 mmol*l^-1 (mean 6.54 mmol*l^-1) were randomized into two therapeutical branches – fluvastatine 40 mg and phenofibrate 200 mg. The patients were followed up ultrasonographically and clinically every 3 months for 2 years.

Results:
The number of vascular accidents was statistically insignificantly lower in a group of phenofibrate – 29 accidents in 24 patients vs 36 accidents in 31 patients in a fluvastatine group. The risk of vascular accidents was significantly higher in patients after a transitory ischemic attack or cerebrovascular accident, in patients with an initially wider atherosclerotic plate, lower level of HDL-cholesterol or its smaller increase in the course of studying, higher level of triglycerides or smaller reduction of their levels during follow-up, and higher ratio of LDL/HDL cholesterol.

Conclusion:
Although the results of NUS study have confirmed better effects of fluvastatine if compared with phenofibrate on slowing down the progression of an atherosclerotic plate in the carotid bifurcation, there was demonstrated no difference in the total numnber of vascular accidents during the first two years of treatment.

Key words:
fluvastatine, phenofibrate, vascular accident, cholesterol

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