Effect of Fenofibrate on Cardiovascular Events and Mortality in Women with Type 2 Diabetes: Results from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study
Abstract Number: 662-P
Authors: MICHAEL D'EMDEN, LI PING LI, DIANA ZANNINO, JAMES BEST, ANTHONY C. KEECH, FIELD STUDY INVESTIGATORS
Institutions: Brisbane, Queensland, Australia, Sydney, NSW, Australia, Melbourne, Victoria, Australia
Results: The FIELD trial compared 200 mg/day micronised fenofibrate with placebo in 9795 patients (3657 women) with type 2 diabetes who were not taking statin therapy. Fenofibrate significantly reduced total CVD events, hospitalization for acute coronary syndromes, amputations, the need for coronary or carotid revascularization, laser therapy for diabetic retinopathy, and progression of proteinuria. The average reduction in LDL cholesterol with fenofibrate was two-thirds larger in women (16.5%) than in men (9.4%) (P<0.001). Effects of fenofibrate on HDL cholesterol did not differ. Fenofibrate reduced the risk of CVD events by 20% in women (P=0.04) and 8% (P=0.2) in men, but the difference between the sexes was not significant (interaction P=0.3).[figure1]Similarly, the risk reductions for CHD events, CHD death, nonfatal MI, stroke, and revascularization were greater for women, although not significantly. After adjustment for CVD medication, uptake of statins, and baseline covariates, CVD event reductions with fenofibrate were larger: 29% for women (P=0.009) and 13% for men (P=0.06) (interaction P=0.1). The results raise the possibility that fenofibrate may reduce cardiovascular risk more in women. The effects could not be accounted for by sex differences in baseline characteristics (including weight), baseline covariates, use of insulin, or use of estrogen.