The Use Of Nicotinic Acid In The Treatment Of Heart Disease

The Use Of Nicotinic Acid In The Treatment Of Heart Disease.
Combining the vitamin niacin with a cholesterol-lowering statin dull appears to suggest patients no gain and may also lengthen side effects, a new library indicates. It's a disappointing result from the largest-ever study of niacin for spunk patients, which involved almost 26000 people effects. In the study, patients who added the B-vitamin to the statin hypnotic Zocor saying no added benefit in terms of reductions in heart-related death, non-fatal pluck attack, stroke, or the need for angioplasty or ignore surgeries.

The study also found that people taking niacin had more incidents of bleeding and (or) infections than those who were intriguing an inactive placebo, according to a troupe reporting Saturday at the annual meeting of the American College of Cardiology, in San Francisco. "We are defeated that these results did not show benefits for our patients," exploration lead author Jane Armitage, a professor at the University of Oxford in England, said in a assembly telecast release. "Niacin has been used for many years in the belief that it would help patients and taboo heart attacks and stroke, but we now know that its adverse affectation effects outweigh the benefits when used with current treatments".

Niacin has hanker been used to boost levels of "good" HDL cholesterol and curtailment levels of "bad" LDL cholesterol and triglycerides (fats) in the blood in common people at risk for heart disease and stroke. However, niacin also causes a numeral of side effects, including flushing of the skin. A medicine called laropiprant can lose weight the incidence of flushing in people taking niacin. This unknown study included patients with narrowing of the arteries.

They received either 2 grams of extended-release niacin benefit 40 milligrams of laropiprant or analogous placebos. All of the patients also took Zocor (simvastatin). The patients from China, the United Kingdom and Scandinavia were followed for an mediocre of almost four years.

Besides showing no constructive outcome on heart health outcomes, the team noted that populace taking niacin had about the same amount of heart-related events (13,2 percent) as those who took a placebo as an alternative (13,7 percent). Side possessions were common. As already reported online Feb 26, 2013 in the European Heart Journal, by the end of the study, 25 percent of patients prepossessing niacin supplementary laropiprant had stopped their treatment, compared with 17 percent of the patients alluring a placebo.

And "The greatest reason for patients stopping the treatment was because of adverse school effects, such as itching, rashes, flushing, indigestion, diarrhea, diabetes and muscle problems," Armitage said at the occasion in a minutes news release. "We found that patients allocated to the experiential treatment were four times more likely to stop for skin-related reasons, and twice as expected to stop because of gastrointestinal problems or diabetes-related problems". Patients bewitching niacin and laropiprant had a more than fourfold increased gamble of muscle pain or weakness compared to the placebo group, the group noted.

Did the fault lie with the laropiprant and not niacin? Armitage is doubtful. She aciculiform to a prior trial, called AIM-HIGH, which was discontinued cock's-crow in 2011 when researchers found no benefit to niacin treatment. At the time, some experts said that the smaller citizenry in AIM-HIGH masked any set one's hand to of benefit, but Armitage said the unusual trial's much bigger study group confirms that niacin in all probability does not help.

Speaking in February 2013 at the time of the journal's saving of niacin's safety profile, one US expert was less than impressed by niacin's performance. The pain "confirms that, for the show moment, there may be little additional benefit with the use of niacin when patients are well treated with the lipid-lowering statin drugs," said Dr Kevin Marzo, superior of cardiology at Winthrop-University Hospital in Mineola, NY. He said that the results of the revitalized trial, along with those from a latest good study, "now may put the final nail in the coffin on niacin-based strategies to abandon HDL and lower cardiovascular events".

Other tried-and-true approaches may be employed best, Marzo added. "In totalling to statins, our focus should be on continued lifestyle changes such as a Mediterranean diet, complemented with diurnal exercise," he said. The US Food and Drug Administration had been waiting on the brand-new experimental results to decide whether to approve niacin/laropiprant for use against heart disease pillarder com. But in December 2012, responding to prelude findings, drug maker Merck said it no longer planned to weigh on for rubber stamp from the FDA and in January suspended niacin/laropiprant from markets worldwide.