AIMS: Treatment with statins has significantly reduced cardiovascular morbidity and mortality, an effect attributed to both the low-density lipoprotein cholesterol (LDL-C) lowering capacity and the pleiotropic actions of these drugs. However, residual risk remains even after intense LDL-C lowering. Therefore, additional treatment with lipid-lowering drugs which improve other lipid parameters and have favourable non-lipid effects may be of clinical value. The aim of the present article is to review the actions of nicotinic acid and comment on the limitations and possible benefits of this drug in clinical practice. METHODS: Relevant articles were identified through a Pubmed search up to July 2010. RESULTS: Nicotinic acid (niacin) improves the lipid profile and has been associated with reduction in morbidity and mortality from cardiovascular disease. This favourable outcome may be due to several beneficial actions of this drug, such as antithrombotic, anti-inflammatory and antioxidant. However, its use has been limited due to side effects, especially flushing. A novel formulation with a prostaglandin D2 receptor antagonist (laropiprant) appears to substantially decrease the frequency and intensity of flushing, without affecting the other properties of niacin. Some concerns regarding treatment with nicotinic acid include impaired glucose metabolism and elevations in uric acid and homocysteine levels. CONCLUSION: Nicotinic acid is a safe supplementary (to statins) lipid lowering agent which may also improve cardiovascular outcomes. Whether its combination with laropiprant will be proved equally effective and more favourable in terms of adverse effects remains to be established by large clinical trials.
AIMS: Treatment with statins has significantly reduced cardiovascular morbidity and mortality, an effect attributed to both the low-density lipoprotein cholesterol (LDL-C) lowering capacity and the pleiotropic actions of these drugs. However, residual risk remains even after intense LDL-C lowering. Therefore, additional treatment with lipid-lowering drugs which improve other lipid parameters and have favourable non-lipid effects may be of clinical value. The aim of the present article is to review the actions of nicotinic acid and comment on the limitations and possible benefits of this drug in clinical practice. METHODS: Relevant articles were identified through a Pubmed search up to July 2010. RESULTS:Nicotinic acid (niacin) improves the lipid profile and has been associated with reduction in morbidity and mortality from cardiovascular disease. This favourable outcome may be due to several beneficial actions of this drug, such as antithrombotic, anti-inflammatory and antioxidant. However, its use has been limited due to side effects, especially flushing. A novel formulation with a prostaglandin D2 receptor antagonist (laropiprant) appears to substantially decrease the frequency and intensity of flushing, without affecting the other properties of niacin. Some concerns regarding treatment with nicotinic acid include impaired glucose metabolism and elevations in uric acid and homocysteine levels. CONCLUSION:Nicotinic acid is a safe supplementary (to statins) lipid lowering agent which may also improve cardiovascular outcomes. Whether its combination with laropiprant will be proved equally effective and more favourable in terms of adverse effects remains to be established by large clinical trials.
Authors: Indumathi Chennamsetty; Karam M Kostner; Thierry Claudel; Manjula Vinod; Sasa Frank; Thomas S Weiss; Michael Trauner; Gerhard M Kostner Journal: J Lipid Res Date: 2012-08-28 Impact factor: 5.922
Authors: Peter Willeit; Lena Tschiderer; Michael J Sweeting; Simon G Thompson; Matthias W Lorenz; Elias Allara; Kathrin Reuber; Lisa Seekircher; Lu Gao; Ximing Liao; Eva Lonn; Hertzel C Gerstein; Salim Yusuf; Frank P Brouwers; Folkert W Asselbergs; Wiek van Gilst; Sigmund A Anderssen; Diederick E Grobbee; John J P Kastelein; Frank L J Visseren; George Ntaios; Apostolos I Hatzitolios; Christos Savopoulos; Pythia T Nieuwkerk; Erik Stroes; Matthew Walters; Peter Higgins; Jesse Dawson; Paolo Gresele; Giuseppe Guglielmini; Rino Migliacci; Marat Ezhov; Maya Safarova; Tatyana Balakhonova; Eiichi Sato; Mayuko Amaha; Tsukasa Nakamura; Kostas Kapellas; Lisa M Jamieson; Michael Skilton; James A Blumenthal; Alan Hinderliter; Andrew Sherwood; Patrick J Smith; Michiel A van Agtmael; Peter Reiss; Marit G A van Vonderen; Stefan Kiechl; Gerhard Klingenschmid; Matthias Sitzer; Coen D A Stehouwer; Heiko Uthoff; Zhi-Yong Zou; Ana R Cunha; Mario F Neves; Miles D Witham; Hyun-Woong Park; Moo-Sik Lee; Jang-Ho Bae; Enrique Bernal; Kristian Wachtell; Sverre E Kjeldsen; Michael H Olsen; David Preiss; Naveed Sattar; Edith Beishuizen; Menno V Huisman; Mark A Espeland; Caroline Schmidt; Stefan Agewall; Ercan Ok; Gülay Aşçi; Eric de Groot; Muriel P C Grooteman; Peter J Blankestijn; Michiel L Bots Journal: Circulation Date: 2020-06-17 Impact factor: 29.690
Authors: Miroslav Zeman; Marek Vecka; František Perlík; Róbert Hromádka; Barbora Staňková; Eva Tvrzická; Aleš Žák Journal: Med Sci Monit Date: 2015-07-25