Introduction : Cardiac events due to coronary artery disease (CAD) are the most common cause of death in all over the world. Myocardial ischemia and its consequent heart failure are considered as common problems and complications of CAD. The purpose of this study was to assess the anti-ischemic effects of fibrates in patients with CAD.

  Methods : This clinical-trial study was conducted on patients with dyslipidemia and CAD referred to the Baqiyatallah university hospital, Tehran, during 2008-2010. A total of 124 patients randomly divided into two groups: the first group (64 patients) received simvastatin (20-60 mg/day)+fenofibrate (200 mg/day) with lipid-limited diet and exercise and the second group (60 patients) received simvastatin (20-60 mg/day) with diet and exercise for one year and the patients were evaluated at the end of this period.

  Results : The mean age was 54.3±6.5 years and 53.2% of patients were male. Metabolic equation index was changed from 4.32±0.5 to 5.68±0.5 at the first group (P<0.001) and 4.43±0.9 to 4.41±1.1 at the other one (P=0.121) and also time of exercise was changed from 5.21±1.81 to 6.01±1.8 (P<0.001) and 5.43±1.26±5.23±1.2 (P=0.089) respectively. No serious adverse effects were seen.

  Conclusion : Lipid-lowering therapy with simvastatin and fenofibrate reduces myocardial ischemia. Therefore it’s recommended to add fenofibrate to statinsin the treatment of dyslipidemia in patients with high risk of cardiovascular accidents as complementary treatment.