Title

Effects of fenofibrate on cardiovascular events in patients with diabetes, with and without prior cardiovascular disease: The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

Date of this Version

3-1-2012

Document Type

Journal Article

Publication Details

Citation only

Tonkin, A, Hunt, D., Voysey, M., Kesäniemi, A., Hamer, A., Waites, J., Mahar, L., Mann, S., Glasziou, P., Forder, P., Simes, J., & Keech, A.C. (2012). Effects of fenofibrate on cardiovascular events in patients with diabetes, with and without prior cardiovascular disease: The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. American Heart Journal, 163(3), 508–514

Access the journal

2012 HERDC submission. FoR codes: 111717; 110399

© Copyright Mosby, 2012

ISSN

1097-6744

Abstract

Background: In the FIELD study, comparison of the effect of fenofibrate on cardiovascular disease (CVD) between those with prior CVD and without was a prespecified subgroup analysis.

Methods: The effects of fenofibrate on total CVD events and its components in patients who did (n = 2,131) and did not (n = 7,664) have a history of CVD were computed by Cox proportional hazards modeling and compared by testing for treatment-by-subgroup interaction. The analyses were adjusted for commencement of statins, use of other CVD medications, and baseline covariates. Effects on other CVD end points were explored.

Results: Patients with prior CVD were more likely than those without to be male, to be older (by 3.3 years), to have had a history of diabetes for 2 years longer at baseline, and to have diabetic complications, hypertension, and higher rates of use of insulin and CVD medications. Discontinuation of fenofibrate was similar between the subgroups, but more patients with prior CVD than without, and also more placebo than fenofibrate-assigned patients, commenced statin therapy. The borderline difference in the effects of fenofibrate between those who did (hazard ratio [HR] 1.02, 95% CI 0.86-1.20) and did not have prior CVD (HR 0.81, 95% CI 0.70-0.94; heterogeneity P = .045) became nonsignificant after adjustment for baseline covariates and other CVD medications (HR 0.96, 95% CI 0.81-1.14 vs HR 0.78, 95% CI 0.67-0.90) (heterogeneity P = .06).

Conclusions: Our findings do not support treating patients with fenofibrate differently based on any history of CVD, in line with evidence from other trials.

This document is currently not available here.

Share

COinS
 

This document has been peer reviewed.