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.
.
.
.
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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.
.
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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