Echocardiographic and Exercise Test Findings in Patients With Dyslipidemia and Coronary Artery Disease Before and After Treatment With Simvastatin With or Without Fenofibrate

Background: Various treatment protocols for dyslipidemia and coronary artery disease have been suggested. In spite of lipid-lowering effects, various effects of statins and fibrates have been reported in the literature.

Objectives: The aim of this study was to assess the cardiac efficacy of Simvastatin with or without fenofibrate on cardiac function.

Patients and Methods: A cohort study was conducted on 124 patients with dyslipidemia and coronary artery disease. Patients were randomly divided into two groups: the first group (n = 64) received Simvastatin (60 - 20 mg/day) and fenofibrate (200 mg/day), and the second group (n = 60) received Simvastatin (20 - 60 mg/day) alone. Treatment lasted 1 year, and the patients were evaluated after treatment.

Results: The mean age was 54.3 ± 6.5 years, and 53.2% of patients were male. Compared to baseline, after 12 months of treatment the lipid profiles of both groups decreased significantly (P < 0.05). The change in left-ventricular ejection fraction in the first group was statistically significant (P = 0.01). The exercise test time and metabolic equivalent of tasks index significantly increased in the first group (P = 0.014, P = 0.006 ), but these changes were not significant in the second group (P = 0.289, P = 0.744).

Conclusions: Lipid-regulating therapies including Simvastatin and fenofibrate improved myocardial function and reduced myocardial ischemia, so combined therapy is recommended for treating dyslipidemia in high-risk patients for cardiovascular problems.