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Journal of the American College of Cardiology

Clinical Articles, News & Views

Niacin reduces CVD events

Niacin reduces cardiovascular disease (CVD) events, through a mechanism which may not be reflected by changes in high-density lipoprotein (HDL) cholesterol concentration, according to a study1 published recently in the Journal of the American College of Cardiology.

Researchers assessed the aggregate body of clinical trial evidence, including data from the recently published AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides: Impact on Global Health Outcomes) trial. These challenged previously available clinical trial data, which failed to demonstrate a reduction in events in patients with established CVD treated with niacin as an adjunct to intensive simvastatin therapy.

The authors identified clinical trials of niacin, alone or combined with other lipid-altering therapy, via MEDLINE. Meta-regression modeled the relationship of differences in on-treatment HDL-lipoprotein cholesterol with the magnitude of effect of niacin on CVD events.

11 eligible trials including 9,959 subjects were identified. Niacin use was associated with a significant reduction in the composite endpoints of any CVD event (p = 0.007) and major coronary heart disease event (p = 0.02), the authors found. No significant association was observed between niacin therapy and stroke incidence (p = 0.65). The magnitude of on-treatment HDL-cholesterol difference between treatment arms was not significantly associated with the magnitude of the effect of niacin on outcomes, the authors concluded.

References

1. Lavigne PM, Karas RH. The current state of niacin in cardiovascular disease prevention. J Am Coll Cardiol 2012. http://dx.doi.org/10.1016/j.jacc.2012.10.030

Published on: December 20, 2012

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