Cited by 182Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCholesterol and Lipid Metabolism

The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.

Relationship of Lipoproteins to Cardiovascular Events

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Abstract

Objectives This study sought to examine the relationship between niacin treatment, lipoproteins, and cardiovascular (CV) outcomes in this secondary analysis of the AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides and Impact on Global Health Outcomes) trial. Background During a 3-year follow-up in 3,414 patients with established CV disease and low high-density lipoprotein cholesterol (HDL-C) levels, combined niacin + low-density lipoprotein cholesterol (LDL-C)-lowering therapy did not reduce CV events compared with LDL-C-lowering therapy alone. Methods Subjects taking simvastatin and/or ezetimibe were randomized to receive extended-release (ER) niacin 1,500 to 2,000 mg or minimal immediate-release niacin (≤ 150 mg) as placebo at bedtime. LDL-C levels in both groups were maintained from 40 to 80 mg/dl. Hazard ratios were estimated by using Cox proportional hazards models for relationships between lipoproteins and the composite endpoint of CV death, myocardial infarction, acute coronary syndrome, ischemic stroke, or symptom-driven revascularization. Results CV outcomes were not associated with ER niacin in any baseline lipoprotein tertile. In a subset of patients in both the highest triglyceride (≥ 198 mg/dl) and lowest HDL-C (<33 mg/dl) tertiles, ER niacin showed a trend toward benefit (hazard ratio: 0.74, p = 0.073). In-trial LDL-C levels, non-HDL-C levels, and the total cholesterol/HDL-C ratio were positively associated with CV events in the control group, but these relationships were absent in the ER niacin group. Conclusions Baseline lipoprotein tertiles did not predict differential benefit or harm with ER niacin added to LDL-C-lowering therapy, but a small dyslipidemic subgroup may benefit. ER niacin attenuated expected relationships of lipoprotein risk factors with CV events, raising the possibility that nonlipoprotein actions of niacin could affect risk. (Niacin Plus Statin to Prevent Vascular Events [AIM-HIGH]; NCT00120289).

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Crossref · 10.1016/j.jacc.2013.07.023

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Metadata

Authors
Guyton, J. R., Slee, A. E., Anderson, T., Fleg, J. L., Goldberg, R. B., Kashyap, M. L., Marcovina, S. M., Nash, S. D., O'Brien, K. D., Weintraub, W. S., Xu, P., Zhao, X.-Q., & Boden, W. E.
Affiliations
  • Duke University (US)
  • University of Calgary (CA)
  • National Heart, Lung, and Blood Institute (US)
  • University of Miami (US)
  • University of California, Irvine (US)
  • University of Washington (US)
  • SUNY Upstate Medical University (US)
  • Albany Stratton VA Medical Center Albany (US)
Corresponding author
Guyton, John R.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2013-10
Volume
62
Issue
17
Pages
1580-1584
ISSN
0735-1097 (ISSN-L)
OpenAlex
W2189339462
Cited by
182
References
23
Citations by year
2026: 3 · 2025: 8 · 2024: 10 · 2023: 6 · 2022: 6 · 2021: 5 · 2020: 15 · 2019: 16 · 2018: 12 · 2017: 15 · 2016: 28 · 2015: 33 · 2014: 22 · 2013: 3
FWCI
26.10
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Heart, Lung, and Blood Institute (U01-HL-081616, U01-HL-081649)
  • Abbott Laboratories
  • Merck & Co.
  • Regeneron
  • Sanofi US
  • Genzyme Corporation, Isis Pharmaceuticals
  • Amgen
  • Amarin
  • GlaxoSmithKline
  • Merck
  • Roche
  • Abbott
  • AstraZeneca
  • Eli Lilly
  • Sanofi
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Cholesterol and Lipid Metabolism
Keywords
nicotinic acid, lipoproteins, cardiovascular events, AIM-HIGH trial, extended-release niacin, low HDL cholesterol, triglycerides, LDL-C lowering therapy, simvastatin, ezetimibe, non-HDL cholesterol, TC/HDL-C ratio, cardiovascular risk prediction
MeSH terms
Aged, Anticholesteremic Agents, Cardiovascular Diseases, Double-Blind Method, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Lipoproteins, Cholesterol, HDL, Male, Middle Aged, Niacin, Prospective Studies, Triglycerides, Global Health, Biomarkers, Treatment Outcome, Metabolic Syndrome

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