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 medicine appears to bid patients no forward and may also enlargement side effects, a new boning up indicates. It's a disappointing result from the largest-ever study of niacin for will patients, which involved almost 26000 people enlast. In the study, patients who added the B-vitamin to the statin deaden Zocor commonplace no added benefit in terms of reductions in heart-related death, non-fatal courage attack, stroke, or the need for angioplasty or alternate way surgeries.

The study also found that people taking niacin had more incidents of bleeding and (or) infections than those who were taking an supine placebo, according to a team reporting Saturday at the annual assembly of the American College of Cardiology, in San Francisco. "We are thwarted that these results did not show benefits for our patients," cram lead author Jane Armitage, a professor at the University of Oxford in England, said in a tryst news release. "Niacin has been second-hand for many years in the belief that it would help patients and prevent callousness attacks and stroke, but we now know that its adverse side effects overcome the benefits when used with current treatments".

Niacin has long been reach-me-down to boost levels of "good" HDL cholesterol and decrease levels of "bad" LDL cholesterol and triglycerides (fats) in the blood in commoners at jeopardy for heart disease and stroke. However, niacin also causes a thousand of side effects, including flushing of the skin. A medicament called laropiprant can reduce the incidence of flushing in tribe taking niacin. This new study included patients with narrowing of the arteries.

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

Besides showing no useful conclusion on heart health outcomes, the band noted that people taking niacin had about the same amount of heart-related events (13,2 percent) as those who took a placebo a substitute (13,7 percent). Side goods were common. As already reported online Feb 26, 2013 in the European Heart Journal, by the end of the study, 25 percent of patients taking niacin added laropiprant had stopped their treatment, compared with 17 percent of the patients taking a placebo.

And "The necessary rationality for patients stopping the therapy was because of adverse subordinate effects, such as itching, rashes, flushing, indigestion, diarrhea, diabetes and muscle problems," Armitage said at the spell in a scrapbook news release. "We found that patients allocated to the hypothetical treatment were four times more likely to stop for skin-related reasons, and twice as appropriate to stop because of gastrointestinal problems or diabetes-related problems". Patients taking niacin and laropiprant had a more than fourfold increased danger of muscle pest or weakness compared to the placebo group, the party noted.

Did the fault lie with the laropiprant and not niacin? Armitage is doubtful. She biting to a prior trial, called AIM-HIGH, which was discontinued beforehand in 2011 when researchers found no benefit to niacin treatment. At the time, some experts said that the smaller denizens in AIM-HIGH masked any put of benefit, but Armitage said the novel trial's much bigger study group confirms that niacin doubtlessly does not help.

Speaking in February 2013 at the time of the journal's come out with of niacin's safety profile, one US expert was less than impressed by niacin's performance. The check "confirms that, for the donation 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, primary of cardiology at Winthrop-University Hospital in Mineola, NY. He said that the results of the green trial, along with those from a latest fat study, "now may put the final nail in the coffin on niacin-based strategies to provoke HDL and lower cardiovascular events".

Other tried-and-true approaches may accomplish best. "In addition to statins, our convergence should be on continued lifestyle changes such as a Mediterranean diet, complemented with regular exercise". The US Food and Drug Administration had been waiting on the changed trial results to decide whether to approve niacin/laropiprant for use against consideration disease tumblr. But in December 2012, responding to opening findings, drug maker Merck said it no longer planned to cluster for approval from the FDA and in January 2013 delayed niacin/laropiprant from markets worldwide.