IMPROVEMENT OF FIBRINOLYSIS AND PLASMA-LIPOPROTEIN LEVELS INDUCED BY GEMFIBROZIL IN HYPERTRIGLYCERIDEMIA

A randomized double-blind study was carried out with gemfibrozil (600 mg b.i.d) vs placebo in 20 patients (twelve males and eight females, age 52+/-3 years, BMI 24.2+/-0.4) suffering from primary hypertriglyceridemia (Fredrickson's type TV). Each group was treated for a 12 week period with gemfibrozil (n=10) or placebo (n=10) patiens) in a double-blind fashion. Total cholesterol, HDL-cholesterol (HDL-C) and its subfractions (HDL(2)-C and HDL(3)-C), blood glucose, Apolipoproteins Al and B, fibrinogen, plasminogen, factor VII, t-PA:Ag and PAI activity pre- and post-venous occlusion (VO) were determined In the gemfibrozil-treated group a significant decrease of total cholesterol and triglycerides and a significant increase of HDL-C and HDL(2)-C were found. During gemfibrozil treatment a significant reduction of factor VII, fibrinogen and plasminogen levels was also observed After 12 weeks of treatment in the gemfibrozil group the release of t-PA:Ag in response to venous occlusion was significantly higher and plasma PAI activity was significantly lower than in placebo group. Moreover positive correlations between HDL cholesterol and t-PA:Ag post-VO (r=056, P<0.01) and between HDL(2)-C cholesterol and t-PA:Ag post-VO (r=0.59, P<0.01) and a negative correlation between triglycerides and t-PA:Ag post-VO (r=- 0.65, P<0.01) were found. The data obtained suggest that gemfibrozil, in addition to the well established lipid-regulating effect, appears to have a positive role in the regulation of reverse cholesterol transport and fibrinolytic system.