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Thursday, December 20, 2012

Current State of Niacin in Cardiovascular Disease Prevention - JACC

The Current State of Niacin in Cardiovascular Disease Prevention: Title and subTitle BreakA Systematic Review and Meta-Regression

Paul M. Lavigne, MD; Richard H. Karas, MD, PhD

Abstract

Objectives This study sought to assess the efficacy of niacin for reducing cardiovascular disease (CVD) events, as indicated by 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.
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Conclusions The consensus perspective derived from available clinical data supports that niacin reduces CVD events and, further, that this may occur through a mechanism not reflected by changes in high-density lipoprotein cholesterol concentration.
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Conclusions

Although potentially indicative of limited efficacy in select patients, the recently published findings of AIM-HIGH are insufficient to alter the aggregate available data supporting the clinical efficacy of niacin therapy as a means to reduce CVD risk. The present analysis demonstrates the summary effect of niacin across a broad clinical population to confer atheroprotection and cautions against the extension of recent isolated findings to substantially alter overall clinical practice. These results thus underscore the need for further analysis, including that offered by the ongoing HPS2-THRIVE (Heart Protection Study 2 Treatment of HDL to Reduce the Incidence of Vascular Events) trial, to more clearly define the role of niacin in current practice.

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