rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2019-15-2-282-288rpcardio-1927Research ArticleTHERAPY GUIDELINESРЕКОМЕНДАЦИИ ПО ЛЕЧЕНИЮCorrection of Hypertriglyceridemia as the Way to Reduce Residual Risk in Diseases Caused by Atherosclerosis. Conclusion of the Advisory Board of the Russian Society of Cardiology, the Russian Scientific Medical Society of Therapists, the Eurasian Association of Therapists, the Russian National Atherosclerosis Society, the Russian Association of Endocrinologists, and the National League of Cardiologic GeneticsКоррекция гипертриглицеридемии с целью снижения остаточного риска при заболеваниях, вызванных атеросклерозом. Заключение Совета экспертов Российского кардиологического общества, Российского научного медицинского общества терапевтов, Евразийской ассоциации терапевтов, Национального общества по изучению атеросклероза, Российской ассоциации эндокринологов и Национальной исследовательской лиги кардиологической генетикиАрутюновП. П.ArutyunovG. P.БойцовС. А.BoytsovS. A.

Москва

ВоеводаМ. И.VoyevodaM. I.ГуревичВ. С.GurevichV. S.ДрапкинаО. М.DrapkinaO. M.

Moscow

КухарчукВ. В.KukharchukV. V.МартыновА. И.MartynovA. I.СергиенкоИ. В.SergiyenkoI. V.igorcardio@mail.ruШестаковаМ. В.ShestakovaM. V.АлиеваА. С.AliyevaA. S.

St. Petersburg

АхмеджановН. М.AkhmedzhanovN. M.БубноваМ. Г.BubnovaM. G.ГалявичА. С.GalyavichА. S.

Казань

ГордеевИ. Г.GordeyevI. G.ЕжовМ. В.EzhovM. V.КарповЮ. А.KarpovYu. A.КонстантиновВ. О.KonstantinovV. O.НедогодаС. В.NedogodaS. V.НифонтовЕ. М.NifontovE. M.ОрловаЯ. А.OrlovaYa. A.ПановА. В.PanovA. V.СайгановС. А.SayganovS. A.СкибицкийВ. В.SkibitskiyV. V.ТарловскаяЕ. И.TarlovskayaE. I.

Nizhniy Novgorod

УразгильдееваС. А.UrazgildeyevaS. A.ХалимовЮ. Ш.KhalimovYu. Sh.Санкт-ПетербургRussian Federation201906052019152282288Copyright © Arutyunov G.P., Boytsov S.A., Voyevoda M.I., Gurevich V.S., Drapkina O.M., Kukharchuk V.V., Martynov A.I., Sergiyenko I.V., Shestakova M.V., Aliyeva A.S., Akhmedzhanov N.M., Bubnova M.G., Galyavich А.S., Gordeyev I.G., Ezhov M.V., Karpov Y.A., Konstantinov V.O., Nedogoda S.V., Nifontov E.M., Orlova Y.A., Panov A.V., Sayganov S.A., Skibitskiy V.V., Tarlovskaya E.I., Urazgildeyeva S.A., Khalimov Y.S., 20192019Арутюнов П.П., Бойцов С.А., Воевода М.И., Гуревич В.С., Драпкина О.М., Кухарчук В.В., Мартынов А.И., Сергиенко И.В., Шестакова М.В., Алиева А.С., Ахмеджанов Н.М., Бубнова М.Г., Галявич А.С., Гордеев И.Г., Ежов М.В., Карпов Ю.А., Константинов В.О., Недогода С.В., Нифонтов Е.М., Орлова Я.А., Панов А.В., Сайганов С.А., Скибицкий В.В., Тарловская Е.И., Уразгильдеева С.А., Халимов Ю.Ш.Arutyunov G.P., Boytsov S.A., Voyevoda M.I., Gurevich V.S., Drapkina O.M., Kukharchuk V.V., Martynov A.I., Sergiyenko I.V., Shestakova M.V., Aliyeva A.S., Akhmedzhanov N.M., Bubnova M.G., Galyavich А.S., Gordeyev I.G., Ezhov M.V., Karpov Y.A., Konstantinov V.O., Nedogoda S.V., Nifontov E.M., Orlova Y.A., Panov A.V., Sayganov S.A., Skibitskiy V.V., Tarlovskaya E.I., Urazgildeyeva S.A., Khalimov Y.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/1927

Tactics for the management of patients with hypertriglyceridemia (HTG) is provided in the conclusion of the Advisory Board. It is demonstrated that HTG is quite prevalent in patients with excessive body weight and is an important component of residual risk. HTG creates additional conditions for the progression of atherosclerosis, and thus it is recommended to test triglyceride in patients with high, very high and extremely high cardiovascular risk. The indication for the pharmacological treatment to reduce the triglycerides concentration is their level more than 2.3 mmol/l. Statins are drugs of choice aimed to decrease the cardiovascular risk in patients with hypercholesterinemia and HTG. Fenofibrate is used to correct HTG; in case of its intolerance or if the triglyceride target level is not reached, ethyl esters of omega-3 polyunsaturated fatty acid can be used in the dosage of 2-4 g daily. In patients with triglyceride level higher than 5.6 mmol/l, fenofibrate is the main option of treatment.

В заключении Совета экспертов приводится тактика ведения пациентов с гипертриглицеридемией (ГТГ). Демонстрируется, что ГТГ является распространенным состоянием у пациентов с избыточным весом и важным компонентом остаточного риска. ГТГ создает дополнительные условия для прогрессирования атеросклероза, поэтому уровень триглицеридов рекомендуется измерить у пациентов с высоким, очень высоким и экстремально высоким уровнем сердечно-сосудистого риска. Показанием к назначению препаратов, снижающих концентрацию триглицеридов, является их уровень более 2,3 ммоль/л. Статины являются препаратами выбора для снижения риска сердечно-сосудистых заболеваний у пациентов высокого риска с гиперхолестеринемией и ГТГ Для коррекции ГТГ применяется фенофибрат, а в случае его непереносимости или при недостижении целевого уровня триглицеридов - омега-3 этиловые эфиры полиненасыщенных жирных кислот в дозе 2-4 г/сут. У пациентов с ГТГ при уровне триглицеридов >5,6 ммоль/л препаратом выбора является фенофибрат.

гипертриглицеридемияфенофибратомега-3 полиненасыщенные жирные кислотысердечно-сосудистые заболеванияостаточный риск сердечно-сосудистых осложненийhypertriglyceridemiafenofibrateomega-3 polyunsaturated fatty acidcardiovascular diseasesresidual risk of cardiovascular complicationsReferencesWHO newsletter. Cardiovascular diseases [cited by Apr 20, 201 9]. Available from: https: //www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).WHO newsletter. Cardiovascular diseases [cited by Apr 20, 201 9]. Available from: https: //www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).Boden W.E., O'Rourke R.A., Teo K.K., et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356(1 5):1 503-1 6. doi:10.1056/NEJMoa070829.Boden W.E., O'Rourke R.A., Teo K.K., et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356(1 5):1 503-1 6. doi:10.1056/NEJMoa070829.Chung S.C., Hlatky M.A., Faxon D., et al. The effect of age on clinical outcomes and health status BARI 2D (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes). J Am Coll Cardiol. 2011 ;58(8):810-9. doi:10.1016/j.jacc.2011.05.020.Chung S.C., Hlatky M.A., Faxon D., et al. The effect of age on clinical outcomes and health status BARI 2D (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes). J Am Coll Cardiol. 2011 ;58(8):810-9. doi:10.1016/j.jacc.2011.05.020.Frye R.L., August P., Brooks M.M., et al. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med. 2009;360(24):2503-1 5. doi:10.1056/NEJMoa0805796.Frye R.L., August P., Brooks M.M., et al. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med. 2009;360(24):2503-1 5. doi:10.1056/NEJMoa0805796.Henderson R.A., Pocock S.J., Clayton TC., et al. Seven-year outcome in the RITA-2 trial: coronary angioplasty versus medical therapy, J Am Coll Cardiol. 2003;42(7):1 1 61 -70. doi:10.1016/S0735-1097(03)00951-3.Henderson R.A., Pocock S.J., Clayton TC., et al. Seven-year outcome in the RITA-2 trial: coronary angioplasty versus medical therapy, J Am Coll Cardiol. 2003;42(7):1 1 61 -70. doi:10.1016/S0735-1097(03)00951-3.Poole-Wilson P.A., Lubsen J., Kirwan B.A., et al. Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial. Lancet. 2004;364(9437):849-57. doi:10.1016/S0140-6736(04)16980-8.Poole-Wilson P.A., Lubsen J., Kirwan B.A., et al. Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial. Lancet. 2004;364(9437):849-57. doi:10.1016/S0140-6736(04)16980-8.Steg P.G., Greenlaw N., Tardif J.C., et al. Women and men with stable coronary artery disease have similar clinical outcomes: insights from the international prospective CLARIFY registry. Eur Heart J. 2012;33(22):2831 - 40. doi:10.1093/eurheartj/ehs289.Steg P.G., Greenlaw N., Tardif J.C., et al. Women and men with stable coronary artery disease have similar clinical outcomes: insights from the international prospective CLARIFY registry. Eur Heart J. 2012;33(22):2831 - 40. doi:10.1093/eurheartj/ehs289.Daly C.A., De Stavola B., Sendon J.L., et al. Predicting prognosis in stable angina-results from the Euroheart survey of stable angina: prospective observational study. BMJ. 2006;332(7536):262-7.doi:10.1136/bmj.38695.605440.AE.Daly C.A., De Stavola B., Sendon J.L., et al. Predicting prognosis in stable angina-results from the Euroheart survey of stable angina: prospective observational study. BMJ. 2006;332(7536):262-7.doi:10.1136/bmj.38695.605440.AE.Steg P.G., Bhatt D.L., Wilson P.W., et al. One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA. 2007;297(1 1):1 1 97-206. doi:10.1001/jama.297.11.1197.Steg P.G., Bhatt D.L., Wilson P.W., et al. One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA. 2007;297(1 1):1 1 97-206. doi:10.1001/jama.297.11.1197.Taylor J. SWEDEHEART: Sweden's new online cardiac registry, the first of its kind. Eur Heart J. 2009;30:21 65-73.Taylor J. SWEDEHEART: Sweden's new online cardiac registry, the first of its kind. Eur Heart J. 2009;30:21 65-73.Castelli W.P. Epidemiology of triglycerides: a view from Framingham. Am J Cardiol. 1 992;70(19):3H-9H. doi:10.1016/0002-9149(92)91083-G.Castelli W.P. Epidemiology of triglycerides: a view from Framingham. Am J Cardiol. 1 992;70(19):3H-9H. doi:10.1016/0002-9149(92)91083-G.Barter P., Gotto A. M., LaRosa J. C., et al. HDL Cholesterol, Very Low Levels of LDL Cholesterol, and Cardiovascular Events. N Engl J Med. 2007;357:1301-10. doi:10.1056/NEJMoa064278.Barter P., Gotto A. M., LaRosa J. C., et al. HDL Cholesterol, Very Low Levels of LDL Cholesterol, and Cardiovascular Events. N Engl J Med. 2007;357:1301-10. doi:10.1056/NEJMoa064278.Carey VJ., Bishop L., Laranjo N., at al. Contribution of high plasma triglycerides and low high-density lipoprotein cholesterol to residual risk of coronary heart disease after establishment of low-density lipoprotein cholesterol control. Am J Cardiol. 2010;1 06(6):757-63. doi:10.1016/j.amjcard.2010.05.002.Carey VJ., Bishop L., Laranjo N., at al. Contribution of high plasma triglycerides and low high-density lipoprotein cholesterol to residual risk of coronary heart disease after establishment of low-density lipoprotein cholesterol control. Am J Cardiol. 2010;1 06(6):757-63. doi:10.1016/j.amjcard.2010.05.002.Aguiar C., Alegria E., Bonadonna R.C., et al. A review of the evidence on reducing macrovascular risk in patients with atherogenic dyslipidaemia: A report from an expert consensus meeting on the role of fenofibrate-statin combination therapy. Atheroscler Suppl. 2015;19:1 -12. doi:10.1016/S1567-5688(15)30001-5.Aguiar C., Alegria E., Bonadonna R.C., et al. A review of the evidence on reducing macrovascular risk in patients with atherogenic dyslipidaemia: A report from an expert consensus meeting on the role of fenofibrate-statin combination therapy. Atheroscler Suppl. 2015;19:1 -12. doi:10.1016/S1567-5688(15)30001-5.Grundy S.M., Becker D., Clark L.T., et al. National Cholesterol Education Program. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Final Report. September 2002. NIH Publication No. 02-5215.Grundy S.M., Becker D., Clark L.T., et al. National Cholesterol Education Program. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Final Report. September 2002. NIH Publication No. 02-5215.Ежов М.В., Сергиенко И.В., Аронов Д.М. и др. Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза, Атеросклероз и Дислипидемии. 2017;3:5-22.Yezhov M.V., Sergienko I.V., Aronov D.M., et al. Diagnosis and correction of lipid metabolism disorders for the prevention and treatment of atherosclerosis, Atherosclerosis and Dyslipidemia. 2017;3:5-22 (In Russ.)Catapano A.L., Graham I., De Backer G., et al. 2016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2016;37(39):2999-3058. doi:10.1093/eurheartj/ehw272.Catapano A.L., Graham I., De Backer G., et al. 2016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2016;37(39):2999-3058. doi:10.1093/eurheartj/ehw272.Hegele R.A., Ginsberg H.N., Chapman M.J., et al. The polygenic nature of hypertriglyceridaemia: implications for definition, diagnosis, and management. Lancet Diabetes Endocrinology. 2013;2(8):655-66. doi:10.1016/S2213-8587(13)70191-8.Hegele R.A., Ginsberg H.N., Chapman M.J., et al. The polygenic nature of hypertriglyceridaemia: implications for definition, diagnosis, and management. Lancet Diabetes Endocrinology. 2013;2(8):655-66. doi:10.1016/S2213-8587(13)70191-8.Ghandehari H., Kamal-Bahl S., Wong N.D. Prevalence and extent of dyslipidemiaand recommended lipid levels in US adults with and without cardiovascular comorbidities: The National Health and Nutrition Examination Survey 2003-2004. Am Heart J. 2008;156 (1 ):112-9. doi:10.1016/j.ahj.2008.03.005.Ghandehari H., Kamal-Bahl S., Wong N.D. Prevalence and extent of dyslipidemiaand recommended lipid levels in US adults with and without cardiovascular comorbidities: The National Health and Nutrition Examination Survey 2003-2004. Am Heart J. 2008;156 (1 ):112-9. doi:10.1016/j.ahj.2008.03.005.Gitt A.K., Drexel H., Feely J., et al. DYSIS Investigators. Persistent lipid abnormalities in statin-treated patients and predictors of LDL-cholesterol goal achievement in clinical practice in Europe and Canada. Eur J Prev Cardiol. 2012;1 9(2):221 -30. doi :10.1177/1741826711400545.Gitt A.K., Drexel H., Feely J., et al. DYSIS Investigators. Persistent lipid abnormalities in statin-treated patients and predictors of LDL-cholesterol goal achievement in clinical practice in Europe and Canada. Eur J Prev Cardiol. 2012;1 9(2):221 -30. doi :10.1177/1741826711400545.Yuan G., Al-Shali K.Z., Hegele R.A. Hypertriglyceridemia: its etiology, effects and treatment. CMAJ. 2007; 176 (8):1 1 13-20. doi:10.1503/cmaj.060963Yuan G., Al-Shali K.Z., Hegele R.A. Hypertriglyceridemia: its etiology, effects and treatment. CMAJ. 2007; 176 (8):1 1 13-20. doi:10.1503/cmaj.060963Aguiar C. Atherogenic dyslipidaemia: the importance of its management in high risk patients. Clin Invest Arterioscl. 2017;29(Supl 2):2-8.Aguiar C. Atherogenic dyslipidaemia: the importance of its management in high risk patients. Clin Invest Arterioscl. 2017;29(Supl 2):2-8.Reaven G.M., Chen YD.L., Jeppesen J., et al. Insulin resistance and hypertriglyceridemia in an individuals with small, dense low density lipoprotein particles. J Clin Invest 1993;92:141.Reaven G.M., Chen YD.L., Jeppesen J., et al. Insulin resistance and hypertriglyceridemia in an individuals with small, dense low density lipoprotein particles. J Clin Invest 1993;92:141.Sarwar N., Sandhu M.S., Ricketts S.L., et al. Triglyceride Coronary Disease Genetics, Consortium and Emerging Risk Factors Collaboration. Triglyceride-mediated pathways and coronary disease: collaborative analysis of 101 studies. Lancet. 2010;375:1 634-9. doi:10.1016/S0140-6736(10)60545-4.Sarwar N., Sandhu M.S., Ricketts S.L., et al. Triglyceride Coronary Disease Genetics, Consortium and Emerging Risk Factors Collaboration. Triglyceride-mediated pathways and coronary disease: collaborative analysis of 101 studies. Lancet. 2010;375:1 634-9. doi:10.1016/S0140-6736(10)60545-4.Ridker P.M., Rifai N., Cook N.R., et al. Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005;294(3):326-33. doi:10.1001/jama.294.3.326.Ridker P.M., Rifai N., Cook N.R., et al. Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005;294(3):326-33. doi:10.1001/jama.294.3.326.International Atherosclerosis Society. An International Atherosclerosis Society position paper: global recommendations for the management of dyslipidaemia. J Clin Lipidol. 2014;8(1 ):29-60.International Atherosclerosis Society. An International Atherosclerosis Society position paper: global recommendations for the management of dyslipidaemia. J Clin Lipidol. 2014;8(1 ):29-60.The ACCORD Study Group. Effects of Combination Lipid Therapy in Type 2 Diabetes Mellitus. N Engl J Med. 2010;362:1 563-74. doi:10.1056/NEJMoa1001282.The ACCORD Study Group. Effects of Combination Lipid Therapy in Type 2 Diabetes Mellitus. N Engl J Med. 2010;362:1 563-74. doi:10.1056/NEJMoa1001282.Bhatt D.L., Steg P.G., Miller M., et al. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. N Engl J Med. 2019;380:1 1 -22. doi:10.1056/NEJMoa1812792.Bhatt D.L., Steg P.G., Miller M., et al. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. N Engl J Med. 2019;380:1 1 -22. doi:10.1056/NEJMoa1812792.Franssen R., Vergeer M., Stroes E.S., Kastelein J.J. Combination statin-fibrate therapy: safety aspects. Diabetes Obes Metab. 2009;1 1(2):89-94. doi:10.1111/j.1463-1326.2008.00917.x.Franssen R., Vergeer M., Stroes E.S., Kastelein J.J. Combination statin-fibrate therapy: safety aspects. Diabetes Obes Metab. 2009;1 1(2):89-94. doi:10.1111/j.1463-1326.2008.00917.x.Fruchart J.C., Duriez P. Mode of action of fibrates in the regulation of triglyceride and HDL-cholesterol metabolism. Drugs Today (Barc). 2006;42(1):39-64. doi:10.1358/dot.2006.42.1.963528.Fruchart J.C., Duriez P. Mode of action of fibrates in the regulation of triglyceride and HDL-cholesterol metabolism. Drugs Today (Barc). 2006;42(1):39-64. doi:10.1358/dot.2006.42.1.963528.Keating G.M., Croom K.F Fenofibrate: a review of its use in primary dyslipidaemia, the metabolic syndrome and type 2 diabetes mellitus. Drugs. 2007;67( 1 );121 -53. doi:10.2165/00003495-200767010-00013.Keating G.M., Croom K.F Fenofibrate: a review of its use in primary dyslipidaemia, the metabolic syndrome and type 2 diabetes mellitus. Drugs. 2007;67( 1 );121 -53. doi:10.2165/00003495-200767010-00013.Feher M.D., Caslake M., Foxton J., et al. Atherogenic lipoprotein phenotype in type 2 diabetes: reversal with micronised fenofibrate. Diabetes Metab Res Rev. 1 999;1 5:395. doi:10.1002/(SICI)1 520-7560(1 9991 1/1 2)15:6<395::AID-DMRR65>3.0.CO;2-N.Feher M.D., Caslake M., Foxton J., et al. Atherogenic lipoprotein phenotype in type 2 diabetes: reversal with micronised fenofibrate. Diabetes Metab Res Rev. 1 999;1 5:395. doi:10.1002/(SICI)1 520-7560(1 9991 1/1 2)15:6<395::AID-DMRR65>3.0.CO;2-N.Baigent C., Blackwell L., Emberson J., et al. Cholesterol Treatment Trialists' (CTT) Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376:1670-81. doi:10.1016/S0140-6736(10)61350-5.Baigent C., Blackwell L., Emberson J., et al. Cholesterol Treatment Trialists' (CTT) Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376:1670-81. doi:10.1016/S0140-6736(10)61350-5.Cannon C.P., Blazing M.A., Giugliano R.P., et al. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med. 2015;372:2387-97. doi:10.1056/NEJMoa1410489.Cannon C.P., Blazing M.A., Giugliano R.P., et al. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med. 2015;372:2387-97. doi:10.1056/NEJMoa1410489.Mark L., Dani G., Fazekas O., et al. Effects of ezetimibe on lipids and lipoproteins in patients with hypercholesterolemia and different apolipoprotein E genotypes. Curr Med Res Opin. 2007;23(7):1 541 -8. doi:10.1185/030079907X199817.Mark L., Dani G., Fazekas O., et al. Effects of ezetimibe on lipids and lipoproteins in patients with hypercholesterolemia and different apolipoprotein E genotypes. Curr Med Res Opin. 2007;23(7):1 541 -8. doi:10.1185/030079907X199817.DAIS investigators. Effect of fenofibrate on progression of coronary-artery disease in type 2 diabetes: the Diabetes Atherosclerosis Intervention Study, a randomised study. Lancet. 2001;357:905-1 0. doi:10.1016/S0140-6736(00)04209-4.DAIS investigators. Effect of fenofibrate on progression of coronary-artery disease in type 2 diabetes: the Diabetes Atherosclerosis Intervention Study, a randomised study. Lancet. 2001;357:905-1 0. doi:10.1016/S0140-6736(00)04209-4.The FIELD study investigators. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet. 2005;366(9500):1849-61. doi :10.1016/S0140-6736(05)67667-2.The FIELD study investigators. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet. 2005;366(9500):1849-61. doi :10.1016/S0140-6736(05)67667-2.Wierzbicki A.S. FIELD of dreams, fields of tears: a perspective on the fibrate trials. Int J Clin Pract. 2006;60(4):442-9. doi:10.1111/j.1368-5031.2006.00882.x.Wierzbicki A.S. FIELD of dreams, fields of tears: a perspective on the fibrate trials. Int J Clin Pract. 2006;60(4):442-9. doi:10.1111/j.1368-5031.2006.00882.x.AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation. 2006;1 1 3:2363-72. doi:10.1161/CIRCULATIONAHA.106.174516.AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation. 2006;1 1 3:2363-72. doi:10.1161/CIRCULATIONAHA.106.174516.Ballantyne C.M., Jones P.H., Kelly M.T., et al. Long-term efficacy of adding fenofibric acid to moderate-dose statin therapy in patients with persistent elevated triglycerides. Cardiovasc Drugs Ther. 2011;25:59-67. doi:10.1007/s10557-011-6280-1.Ballantyne C.M., Jones P.H., Kelly M.T., et al. Long-term efficacy of adding fenofibric acid to moderate-dose statin therapy in patients with persistent elevated triglycerides. Cardiovasc Drugs Ther. 2011;25:59-67. doi:10.1007/s10557-011-6280-1.Roth E.M., McKenney J.M., Kelly M.T., et al. Efficacy and safety of rosuvastatin and fenofibric acid combination therapy versus simvastatin monotherapy in patients with hypercholesterolemia and hypertriglyceridemia: a randomized, double-blind study. Am J Cardiovasc Drugs. 2010;10(3):175-86. doi :10.2165/11533430-000000000-00000.Roth E.M., McKenney J.M., Kelly M.T., et al. Efficacy and safety of rosuvastatin and fenofibric acid combination therapy versus simvastatin monotherapy in patients with hypercholesterolemia and hypertriglyceridemia: a randomized, double-blind study. Am J Cardiovasc Drugs. 2010;10(3):175-86. doi :10.2165/11533430-000000000-00000.Farnier M., Ducobu J., Bryniarski L. Efficacy and safety of adding fenofibrate 160 mg in high-risk patients with mixed hyperlipidemia not controlled by pravastatin 40 mg monotherapy. Am J Cardiol. 2010;106:787-92. doi:10.1016/j.amjcard.2010.05.005.Farnier M., Ducobu J., Bryniarski L. Efficacy and safety of adding fenofibrate 160 mg in high-risk patients with mixed hyperlipidemia not controlled by pravastatin 40 mg monotherapy. Am J Cardiol. 2010;106:787-92. doi:10.1016/j.amjcard.2010.05.005.Farnier M., Steinmetz A., Retterstol K., et al. Fixed-dose combination fenofibrate/ pravastatin 160/40 mg versus simvastatin 20 mg monotherapy in adults with type 2 diabetes and mixed hyperlipidemia uncontrolled with simvastatin 20 mg: a double-blind, randomized comparative study. Clin Ther, 2011 ;33(1 ):1-12. doi:10.1016/j.clinthera.2011.02.006.Farnier M., Steinmetz A., Retterstol K., et al. Fixed-dose combination fenofibrate/ pravastatin 160/40 mg versus simvastatin 20 mg monotherapy in adults with type 2 diabetes and mixed hyperlipidemia uncontrolled with simvastatin 20 mg: a double-blind, randomized comparative study. Clin Ther, 2011 ;33(1 ):1-12. doi:10.1016/j.clinthera.2011.02.006.Jones P.H., Cusi K., Davidson M.H., et al. Efficacy and safety of fenofibric acid co-administered with low- or moderate-dose statin in patients with mixed dyslipidemia and type 2 diabetes mellitus. Am J Cardiovasc Drugs. 2010;1 0(2):73-84. doi:10.2165/10061630-000000000-00000.Jones P.H., Cusi K., Davidson M.H., et al. Efficacy and safety of fenofibric acid co-administered with low- or moderate-dose statin in patients with mixed dyslipidemia and type 2 diabetes mellitus. Am J Cardiovasc Drugs. 2010;1 0(2):73-84. doi:10.2165/10061630-000000000-00000.

The authors declare that there are no conflicts of interest present.