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Link Between Nicotinic Acid and Atherosclerosis Examined

Study finds nicotinic acid reduces atherosclerosis in statin-treated patients with low HDL-C levels

WEDNESDAY, Oct. 28 (HealthDay News) -- In patients with low high-density lipoprotein cholesterol (HDL-C) and atherosclerotic disease, daily use of high-dose nicotinic acid may help reduce atherosclerosis, according to research completed in the United Kingdom and published in the Nov. 3 Journal of the American College of Cardiology.

Justin M.S. Lee, of the University of Oxford in the United Kingdom, and colleagues analyzed data from 71 patients with low HDL-C and either type 2 diabetes with coronary artery disease or carotid or peripheral arterial atherosclerosis. Patients were randomly assigned to receive placebo or 2 grams of modified-release nicotinic acid added to daily statin regimen. The primary end point was change in carotid artery wall area at 12 months, as assessed by MRI.

The researchers found that, in the treated group, HDL-C increased by 23 percent and low-density lipoprotein cholesterol fell by 19 percent. At 12 months, the nicotinic acid group also had decreased carotid wall area compared with the placebo group. Larger plaques were more disposed to changes in size in both the treatment and control groups.

"This important study by Lee et al provides direct MRI evidence that niacin reduces carotid atherosclerosis in statin-treated patients with low HDL-C levels. These results strengthen the hypothesis that combination niacin + statin therapy will reduce cardiovascular disease events compared with statin monotherapy. We eagerly await the results of these ongoing pivotal trials," writes the author of an accompanying editorial.

The study was funded by Merck KGaA. A co-author reported financial relationships with several pharmaceutical companies.

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