Effect of niacin therapy on cardiovascular outcomes in patients with coronary artery disease

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Jasleen K Duggal1, Mukesh Singh, Navneet Attri

  • 1Chicago Medical School and Affiliated Hospitals, Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA.

Journal of Cardiovascular Pharmacology and Therapeutics
|March 9, 2010
PubMed

Insights

Niacin (vitamin B3) significantly reduced cardiovascular events like heart attacks and strokes in patients with coronary artery disease. While it showed a trend towards lower cardiac mortality, this decrease was not statistically significant in this meta-analysis.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Public Health

Background:

  • Niacin (vitamin B3) is known to increase high-density lipoprotein cholesterol (HDL) levels.
  • Previous trials on niacin's cardiovascular outcomes in patients with coronary disease yielded inconsistent results.
  • A meta-analysis was needed to clarify niacin's effect on cardiovascular events in this population.

Purpose of the Study:

  • To evaluate the effect of niacin on cardiovascular outcomes.
  • To analyze data from randomized placebo-controlled trials (RCTs) in patients with coronary artery disease.

Main Methods:

  • Systematic search of PubMed, EMBASE, and Cochrane library databases.
  • Inclusion of seven randomized placebo-controlled trials with 5137 patients.
  • Meta-analysis using Mantel-Haenszel fixed-effect model to assess treatment effect.

Main Results:

  • Niacin therapy significantly reduced coronary artery revascularization (RR: 0.307; P = .001).
  • Niacin significantly decreased nonfatal myocardial infarction (MI) (RR: 0.719; P = .000) and stroke/transient ischemic attack (TIA) (RR: 0.759; P = .012).
  • A possible but nonsignificant decrease in cardiac mortality was observed (RR: 0.883; P = .066).

Conclusions:

  • Niacin use in secondary prevention is associated with a significant reduction in cardiovascular events.
  • Niacin may offer a small, though not statistically significant, decrease in coronary and cardiovascular mortality.
  • Further research may be warranted to fully elucidate niacin's impact on mortality outcomes.
Abstract

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