Improved Blood Lipids Don’t Ward Off Death in Diabetes

Another arm of the ACCORD trial was equally disappointing to the investigators. ACCORD stands for Action to Control Cardiovascular Risk in Diabetes, and blood fats such as cholesterol and triglycerides are important risk factors. In this part of the study, more than 5500 people with type 2 diabetes were given the cholesterol-lowering drug simvastatin and randomly assigned to take either fenofibrate or placebo as well. Fenofibrate is supposed to help lower triglycerides and raise beneficial HDL cholesterol. Triglycerides are blood fats that are often elevated in diabetes; they are an independent risk factor for heart disease.
Although people taking fenofibrate did have lower triglycerides, there were no differences between the two groups with respect to the primary outcomes of heart attack, stroke or death. There was a hint that men might benefit from dual therapy while women might experience harm, but the data are not clear enough to be sure of that conclusion.
[New England Journal of Medicine, April 29, 2010]