May 17, 2026Journal of the American College of Cardiology
Fifteen year mortality in Coronary Drug Project patients: Long-term benefit with niacin
Key result
Niacin cuts 15-year all-cause mortality ~11% vs placebo in men with previous myocardial infarction.
- P=0.0004
- n=8,341
Why the study?
Does niacin reduce long-term mortality in men with previous myocardial infarction?
Population
8,341 men aged 30 to 64 years with electrocardiogram-documented previous myocardial infarction
Comparison
Niacin treatment vs Placebo
Design
RCT
Follow-up
mean 15 years
Authors
Discussion
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Implication
Niacin treatment in men with previous myocardial infarction is associated with a significant reduction in long-term all-cause mortality at 15 years, despite no mortality benefit during the initial trial period.
Key Points
- To evaluate the fifteen-year mortality outcomes of five lipid-influencing medications in men with documented prior myocardial infarction.
- Long-term post-trial follow-up of a randomized clinical trial conducted between 1966 and 1975 involving 8,341 men aged 30 to 64 years with electrocardiogram-documented previous myocardial infarction.
- Participants received either one of five lipid-altering treatments or placebo, with follow-up extending to a mean of 15 years (nearly 9 years after treatment ended).
- All-cause mortality was 11% lower in the niacin group compared to the placebo group (52.0% vs. 58.2%; p = 0.0004).
- Clofibrate demonstrated no survival efficacy, while dextrothyroxine and two estrogen arms were stopped early due to adverse effects, leaving only niacin with a late mortality benefit.
Study Design
Type
RCT (n=8,341)
Structured PICO
Does niacin reduce long-term mortality in men with previous myocardial infarction?
P
Population
8,341 men aged 30 to 64 years with electrocardiogram-documented previous myocardial infarction, followed for a mean of 15 years.
I
Intervention
Niacin treatment (part of a trial assessing five lipid-influencing drugs)
C
Comparator
Placebo
O
Outcome
Mortality from all causes at mean 15 years follow-uphard clinical
Main Result
Absolute Event Rate: 52% vs 58.2%
p-value: p=0.0004
Niacin treatment in men with previous myocardial infarction is associated with a significant reduction in long-term all-cause mortality at 15 years, despite no mortality benefit during the initial trial period.
Cite This Study
Canner et al. (1986) conducted an RCT in previous myocardial infarction (n=8,341). Niacin vs. Placebo was evaluated on mortality from all causes (p=0.0004). Niacin treatment significantly reduced all-cause mortality compared to placebo at 15-year follow-up (52.0% vs 58.2%; p=0.0004) in men with previous myocardial infarction.