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  • 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

    Author(s)
    Tonkin, Andrew
    Hunt, David
    Voysey, Merryn
    Kesaniemi, Antero
    Hamer, Andrew
    Waites, Jonathon
    Mahar, Leo
    Mann, Stewart
    Glasziou, Paul
    Forder, Peta
    Simes, John
    Keech, Anthony
    Davoren, Peter
    Griffith University Author(s)
    Davoren, Peter M.
    Year published
    2012
    Metadata
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    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 ...
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    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.
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    Journal Title
    American Heart Journal
    Volume
    163
    Issue
    3
    DOI
    https://doi.org/10.1016/j.ahj.2011.12.004
    Subject
    Medical and Health Sciences not elsewhere classified
    Cardiorespiratory Medicine and Haematology
    Public Health and Health Services
    Publication URI
    http://hdl.handle.net/10072/47597
    Collection
    • Journal articles

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