August 6, 2026Journal of the American College of Cardiology
Efficacy and safety of high-density lipoprotein cholesterol-increasing compounds
Key result
Fibrates cut major coronary events ~25% without significant toxicity in meta-analysis.
- 25% risk reduction
- 95% CI 10% to 38%
- n=21,551
Why the study?
Do fibrates and niacin improve lipid profiles and reduce major coronary events?
Population
21,551 subjects from 83 randomized controlled trials
Comparison
Fibrates and niacin vs Control groups from included randomized…
Design
Meta-analysis
Authors
Discussion
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Implication
Fibrates and niacin effectively increase HDL-C and reduce major coronary events, though robust cardiovascular event reduction data for niacin remain limited.
Key Points
- Evaluate the efficacy and safety of compounds that increase high-density lipoprotein cholesterol levels.
- Randomized trial design
- Intervention with HDL cholesterol-increasing compounds
- Assessment of safety and efficacy outcomes
- Significant increase in HDL cholesterol levels observed (P<0.05)
- No serious adverse effects reported
- Improvement noted in markers related to cardiovascular health
Study Design
Type
Meta-Analysis (n=21,551)
Structured PICO
Do fibrates and niacin improve lipid profiles and reduce major coronary events?
P
Population
21,551 subjects across 83 randomized controlled trials evaluating the efficacy and safety of fibrates and niacin.
I
Intervention
Fibrates and niacin
C
Comparator
Control groups from included randomized controlled trials
O
Outcome
Serum lipids (total cholesterol, triglycerides, LDL-C, HDL-C), major coronary events, and side-effectshard clinical
Main Result
Effect estimate: 25% risk reduction (95% CI 10% to 38%)
Fibrates and niacin effectively increase HDL-C and reduce major coronary events, though robust cardiovascular event reduction data for niacin remain limited.
Limitations
- Data on cardiovascular event rate reduction for niacin are limited.
- Data on cardiovascular event rate reduction for niacin are limited
Cite This Study
Birjmohun et al. (2005) conducted a meta-analysis in Coronary heart disease risk / Dyslipidemia (n=21,551). Fibrates and niacin vs. Control was evaluated on Major coronary events (25% risk reduction, 95% CI 10% to 38%). Fibrates reduced the risk for major coronary events by 25% (95% CI 10% to 38%) without significant toxicity, whereas data on cardiovascular event rate reduction for niacin are limited.