Trial reportAmerican heart journal2009
Atheroprotective lipoprotein effects of a niacin-simvastatin combination compared to low- and high-dose simvastatin monotherapy.
Trial report in American heart journal, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Niacin for primary and secondary prevention of cardiovascular events.The Cochrane database of systematic reviews · 2017 · on this mapPooled it
- Systematic review: Evaluating the effect of lipid-lowering therapy on lipoprotein and lipid values.Cardiovascular drugs and therapy · 2013Pooled it
- Niacin Therapy Increases High-Density Lipoprotein Particles and Total Cholesterol Efflux Capacity But Not ABCA1-Specific Cholesterol Efflux in Statin-Treated Subjects.Arteriosclerosis, thrombosis, and vascular biology · 2016 · on this mapTrial
- Trial
- Are post-treatment low-density lipoprotein subclass pattern analyses potentially misleading?Lipids in health and disease · 2010Trial
- Combination of niacin extended-release and simvastatin results in a less atherogenic lipid profile than atorvastatin monotherapy.Vascular health and risk management · 2010Trial
- Dysfunctional High-Density Lipoprotein Cholesterol and Coronary Artery Disease: A Narrative Review.Journal of personalized medicine · 2024Review
- Changes in glucose metabolism, C-reactive protein, and liver enzymes following intake of NAD + precursor supplementation: a systematic review and meta-regression analysis.Nutrition & metabolism · 2024Article
- High-density lipoprotein subclass measurements improve mortality risk prediction, discrimination and reclassification in a cardiac catheterization cohort.Atherosclerosis · 2016Article
- Dysfunctional HDL and atherosclerotic cardiovascular disease.Nature reviews. Cardiology · 2016Review
- Niacin Therapy, HDL Cholesterol, and Cardiovascular Disease: Is the HDL Hypothesis Defunct?Current atherosclerosis reports · 2015Review
- Role of HDL in those with diabetes.Current cardiology reports · 2014Review
- HDL: to treat or not to treat?Current atherosclerosis reports · 2014Review
- Increasing spatial resolution of 3T MRI scanning improves reproducibility of carotid arterial wall dimension measurements.Magma (New York, N.Y.) · 2014Article
- Niacin: another look at an underutilized lipid-lowering medication.Nature reviews. Endocrinology · 2012Review
- Clinical trials of HDL cholesterol-raising therapy: what have we learned about the HDL hypothesis from AIM-HIGH?Current atherosclerosis reports · 2012Article
- Do We Know When and How to Lower Lipoprotein(a)?Current treatment options in cardiovascular medicine · 2010Article
- Therapeutic options to further lower C-reactive protein for patients on statin treatment.Current atherosclerosis reports · 2010Review
- Acipimox, an inhibitor of lipolysis, attenuates atherogenesis in LDLR-null mice treated with HIV protease inhibitor ritonavir.Arteriosclerosis, thrombosis, and vascular biology · 2009Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundNiacin has multiple lipoprotein effects that may provide cardiovascular benefit when added to statin monotherapy.
methodsIn this randomized, placebo-controlled trial (n = 75) of magnetic resonance imaging of carotid atherosclerosis, we performed a secondary comparison of combination niacin-statin (simvastatin 20 mg/Niacin-ER 2G [S20/N]) to monotherapy with moderate (20 mg [S20]) and high-dose (80 mg [S80]) simvastatin on lipids, apolipoproteins (apo), low density lipoprotein (LDL) and high density lipoprotein (HDL) particle subclasses, and inflammatory markers.
resultsAt baseline, average age was 71, 72% were male, 62.5% used statins, and average LDL-cholesterol was 111 mg/dL. At 12 months, S20/N, compared to S80, significantly reduced apoB (-36.6% vs -11.9%; P = .05) and lipoprotein(a) (-18% vs +3.5%; P = .001) and had at least an equivalent effect on LDL-cholesterol (-39.3% vs -24.3%; P = .24). The combination reduced the proportion of subjects with atherogenic LDL pattern-B (50% to 11.5%) compared to S80 (56% to 56%) (P = .01). Despite increases in plasma free fatty acids (+62.4%; F = 5.65, P = .005 vs S20 and S80), plasma triglycerides (-29.4%; F = 6.88, P = .002 vs S20 and S80), and very-low-density lipoprotein (-44.2%; F = 7.94, P < .001 vs S20 and S80), levels were reduced by S20/N. S20/N increased HDL-cholesterol levels (+18.1%) as compared to S20 (0%) and S80 (+5.9%) (P < .001 vs both statin arms), largely due to an increase in HDL particle size (+4.6%; P = .01 vs both statin arms).
conclusionsWe demonstrate that full-dose niacin/moderate-dose simvastatin combination has sustained benefits on atherogenic apoB lipoproteins, at least comparable to high-dose simvastatin, while also raising HDL-cholesterol. Results of large clinical trials will inform whether niacin-statin combinations reduce cardiovascular disease events.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.