The Peter Attia Drive #23 - Tom Dayspring, M.D., FACP, FNLA – Part IV of V: Statins, ezetimibe, PCSK9 inhibitors, niacin, cholesterol and the brain
45 snips
Oct 18, 2018 AI Snips
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Fibrates for Triglycerides and HDL
- Fibrates lower triglycerides and raise HDL, potentially offering microvascular benefits.
- Consider fibrates for patients with high triglycerides and low HDL despite statin therapy.
VA-HIT Trial and Gemfibrozil
- The VA-HIT trial showed gemfibrozil reduced events in patients with coronary artery disease, low HDL, and high triglycerides.
- Surprisingly, the benefit was linked to LDL particle count, not HDL raising.
Underutilization of Fibrates
- Fibrates are underutilized, especially by younger lipidologists unfamiliar with their benefits.
- They may be more effective than fish oil for certain patients, particularly those with microvascular disease.