Results of the Bezafibrate Coronary Atherosclerosis Intervention Trial (BECAIT) and an update on trials now in progress.

Bezafibrate is a latest generation fibrate derivative that substantially reduces total plasma cholesterol and triglyceride concentrations and increases high density lipoprotein (HDL) cholesterol. The Bezafibrate Coronary Atherosclerosis Intervention Trial (BECAIT) was a double-blind, placebo-controlled trial over 5 years to assess the angiographic benefits of bezafibrate retard (400 mg. day (-1) in young, male, post-myocardial infarction (post-MI) patients. The trial demonstrated that without lowering serum low density lipoprotein cholesterol, progression of coronary atherosclerosis was prevented and the coronary event rate reduced. In subgroup analyse, bezafibrate decreased the rate of progression of coronary atherosclerosis and coronary event rate in young post-MI patients, primarily by slowing the progression of mild-to-moderate lesions. Additional studies are underway to explore further the benefits of this fibrate in coronary heart disease. The Bezafibrate Infarction Prevention study is the first trial to investigate the effects of raising HDL cholesterol and lowering triglycerides in patients with established coronary disease. The Lower Extremity Arterial Disease Event Reduction study is assessing the benefit of lowering fibrinogen in the prevention of major ischaemic heart disease and stroke in patients with peripheral vascular disease.