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Effects of High-Dose Modified-Release Nicotinic Acid on Atherosclerosis and Vascular Function
Open accessAbstract
Objectives Our aim was to determine the effects of high-dose (2 g) nicotinic acid (NA) on progression of atherosclerosis and measures of vascular function.Background NA raises high-density lipoprotein cholesterol (HDL-C) and reduces low-density lipoprotein cholesterol and is widely used as an adjunct to statin therapy in patients with coronary artery disease. Although changes in plasma lipoproteins suggest potential benefit, there is limited evidence of the effects of NA on disease progression when added to contemporary statin treatment.Methods We performed a double-blind, randomized, placebo-controlled study of 2 g daily modified-release NA added to statin therapy in 71 patients with low HDL-C (<40 mg/dl) and either: 1) type 2 diabetes with coronary heart disease; or 2) carotid/peripheral atherosclerosis. The primary end point was the change in carotid artery wall area, quantified by magnetic resonance imaging, after 1 year.Results NA increased HDL-C by 23% and decreased low-density lipoprotein cholesterol by 19%. At 12 months, NA significantly reduced carotid wall area compared with placebo (adjusted treatment difference: -1.64 mm(2) [95% confidence interval: -3.12 to -0.16]; p = 0.03). Mean change in carotid wall area was -1.1 +/- 2.6 mm(2) for NA versus +1.2 +/- 3.0 mm(2) for placebo. In both the treatment and placebo groups, larger plaques were more prone to changes in size (r = 0.4, p = 0.04 for placebo, and r = -0.5, p = 0.02 for NA).Conclusions In statin-treated patients with low HDL-C, high-dose modified-release NA, compared with placebo, significantly reduces carotid atherosclerosis within 12 months. (Oxford Niaspan Study: Effects of Niaspan on Atherosclerosis and Endothelial Function; NCT00232531).
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“In statin-treated patients with low HDL-C, high dose, modified release nicotinic acid, compared with placebo, significantly reduced carotid wall area, quantified by magnetic resonance imaging after 1 year.133”
From ESC/EAS Guidelines for the management of dyslipidaemias (2011) · cites this paper as [133]
In the citing paper
“A recent meta-analysis suggests that nicotinic acid alone or in combination with statin may add further benefit in stroke prevention.133”
From ESC/EAS Guidelines for the management of dyslipidaemias (2011) · cites this paper as [133]
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Metadata
- Authors
- Lee, J. M. S., Robson, M. D., Yu, L.-M., Shirodaria, C. C., Cunnington, C., Kylintireas, I., Digby, J. E., Bannister, T., Handa, A., Wiesmann, F., Durrington, P. N., Channon, K. M., Neubauer, S., & Choudhury, R. P.
- Affiliations
- University of Oxford (GB)
- University of Manchester (GB)
- Corresponding author
- Choudhury, Robin P.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 54
- Issue
- 19
- Pages
- 1787-1794
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2104463342
- Cited by
- 246
- References
- 53
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 11 · 2023: 4 · 2022: 4 · 2021: 3 · 2020: 4 · 2019: 7 · 2018: 8 · 2017: 8 · 2016: 8 · 2015: 13 · 2014: 16 · 2013: 29 · 2012: 40
- FWCI
- 43.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- AstraZeneca
- GlaxoSmithKline
- Sanofi
- Merck KGaA
- Wellcome Trust
- National Institute for Health and Care Research (NF-SI-0508-10247)
- University of Oxford
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Cholesterol and Lipid Metabolism
- Keywords
- nicotinic acid, atherosclerosis, carotid intima-media thickness, vascular function, statin therapy, low HDL cholesterol, type 2 diabetes, coronary artery disease, endothelial function, lipid-lowering therapy
- MeSH terms
- Aged, Hypolipidemic Agents, Carotid Artery Diseases, Delayed-Action Preparations, Double-Blind Method, Drug Administration Schedule, Female, Humans, Cholesterol, HDL, Cholesterol, LDL, Magnetic Resonance Imaging, Male, Middle Aged, Niacin, Time Factors, Triglycerides, Confounding Factors, Epidemiologic, Treatment Outcome, Tunica Intima, Tunica Media
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