FIBRINOLYTIC EFFECT OF GEMFIBROZIL VERSUS PLACEBO ADMINISTRATION IN RESPONSE TO VENOUS OCCLUSION

Impact of hypertriglyceridemia on atherosclerotic vascular disease and thromboembolic events is recently emphasized by primary prevention studies on the development of coronary artery disease. A randomized double-blind study was carried out with gemfibrozil (600 mg b.i.d.) versus placebo in 20 patients (12 males and 8 females, age 52 +/- 3 years, BMI 24.2 +/- 0.4) suffering from primary hypertriglyceridemia (Fredrickson's type IV). After a 4-week stabilization period in which administration of lipid-lowering drugs was stopped and an isocaloric diet was prescribed, patients were randomized into two groups. Each group was treated for a 12 week period with gemfibrozil (10 patients) or placebo (10 patients) in a double-blind fashion. Every 4 weeks triglycerides, total cholesterol, HDL-cholesterol, blood glucose and Apolipoproteins A1 and B were determined. At baseline and at the end of the treatment period a venous occlusion test was performed in all subjects. Before and after 10 min venous stasis were measured: t-PA antigen, PAI activity, fibrinogen, plasminogen, Factor VII and haematocrit. In the gemfibrozil-treated group a significant decrease of triglycerides and a significant increase of HDL-C was found. During gemfibrozil treatment a significant reduction of Factor VII, fibrinogen and plasminogen levels either before or after venous occlusion was also observed. After 12 weeks of treatment in the gemfibrozil group the release of t-PA in response to venous occlusion was significantly higher and plasma PAI activity was significantly lower than in placebo group, suggesting a profibrinolytic effect of the drug.