Why the study?
Despite statin therapy, residual cardiovascular risk remains, but previous evidence for HDL-C-raising niacin has been challenged by negative outcomes in two large randomized controlled trials.
Does niacin reduce cardiovascular events in patients with or at risk of atherosclerotic cardiovascular disease on background statin therapy?
Does niacin reduce cardiovascular events in patients with or at risk of atherosclerotic cardiovascular disease on background statin therapy?
This review summarizes the current evidence regarding niacin for cardiovascular risk reduction, highlighting that recent large trials have shown negative outcomes when added to statin therapy.
Reinforces avoiding routine niacin with statins; confirms negative RCT outcomes and leaves open only narrow subgroup questions.
Despite significant risk reduction with statin therapy, there remains a residual cardiovascular risk. It has been seen that aggressive statin therapy in high risk patients may not lower the low-density lipoprotein cholesterol to goal in up to 40% of patients. Niacin is a potent high-density lipoprotein cholesterol-raising drug, and has been proposed as an attractive approach to reduce cardiac events in patients with or at risk of atherosclerotic cardiovascular disease. However, previous evidence for niacin has been challenged by negative outcomes in two large, randomized, controlled trials comparing niacin to placebo with background statin therapy. In this review, summarize the currently available evidence for the role of niacin treatment for reducing the risk of cardiovascular events in current practice.
No takes yet. Share an insight, caveat, or question.
Sharma et al. (2019) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: