Pleiotropic actions of fenofibrate on the heart

Fenofibrate is a third-generation fibric acid derivative employed clinically as a hypolipidemic agent to lessen the risk caused by atherosclerosis. Dyslipidemia is a condition associated with elevated levels of low-density lipoproteins (LDL), very low-density lipoproteins (VLDL) and triglycerides, and reduced levels of high-density lipoproteins (HDL) in the circulation. Fenofibrate has an ability to diminish LDL, VLDL and triglycerides and pertinently augment HDL, and thus it is used to manage dyslipidemia. The lipid lowering effects of fenofibrate are classically mediated via an activation of peroxisome proliferator-activated receptor-alpha (PPAR-α). Recent studies demonstrated numerous pleiotropic effects of fenofibrate on the heart that afford direct myocardial protection besides its lipid lowering effects. Fenofibrate has an additional potential to prevent the induction and progression of hypertensive heart damage, cardiac hypertrophy, heart failure, myocarditis, lipotoxic cardiomyopathy and vascular endothelial dysfunction-associated cardiovascular abnormalities. In this review, we critically discussed recently identified pleiotropic actions of fenofibrate on the heart. Moreover, the novel cardioprotective effects of fenofibrate against various cardiac disorders have been delineated.