Research on improvement of coronary artery endothelial function by PPAR-α agonist in patients with hypertriglyceridemia

Objective We investigated the effect of the peroxisome proliferator-activated receptor-α(PPAR-α)agonist on coronary artery endothelial function in patients with hypertriglyceridemia.Methods Fifty eight patients with hypertriglyceridemia were divided into 2 groups:control group(no treatment;n=23)and fenofibrate treatment group(n=35),200 mg/d,for 12 weeks.The patients had undergone rest and adenosine treatment to induce hyperemia for quantification of coronary flow velocity reserve(CFVR)by noninvasive Doppler echocardiography before treatment and after 12-week follow-up respectively.Results CFVR was significantly improved with fenofibrate treatment as compared with baseline level and control group(3.14±0.36 vs.2.80±0.58 and 2.79±0.65,P0.01 and 0.05,respectively),with no difference between baseline levels and untreated controls.In addition,at 12 weeks,plasma level of homocysteine was significantly increased with fenofibrate treatment as compared with at baseline and control group.Plasma level of MCP-1 was significantly reduced from baseline to 12 weeks after fenofibrate treatment.Conclusions Treatment with PPAR-α agonist fenofibrate significantly improved CFVR in patients with hypertriglyceridemia.This endothelial protective effect may be reduced in part by the side effect of increasing homocysteine.