Effects of oral niacin on endothelial dysfunction in patients with coronary artery disease: Results of the randomized, double-blind, placebo-controlled INEF study

6533b823fe1ef96bd127f523

RESEARCH PRODUCT

Effects of oral niacin on endothelial dysfunction in patients with coronary artery disease: Results of the randomized, double-blind, placebo-controlled INEF study

Mir Abolfazl Ostad Philipp S. Wild Fabian Stieber Karl J. Lackner Thomas Münzel Reinhard Schinzel Ascan Warnholtz Ulrich Walter Veronika Elsner Dirk Peetz Stefan Blankenberg

subject

Blood Glucose Male medicine.medical_specialty Brachial Artery Vasodilator Agents Administration Oral Coronary Artery Disease Placebo Niacin Gastroenterology Coronary artery disease Nitroglycerin chemistry.chemical_compound High-density lipoprotein Double-Blind Method Internal medicine medicine.artery medicine Humans Prospective Studies Phosphorylation Endothelial dysfunction Brachial artery Triglycerides Aged Ultrasonography Vascular disease business.industry Cholesterol HDL Microfilament Proteins nutritional and metabolic diseases Cholesterol LDL Middle Aged Phosphoproteins medicine.disease Vasodilation B vitamins Treatment Outcome Endocrinology chemistry Delayed-Action Preparations Female lipids (amino acids peptides and proteins)Endothelium Vascular Cardiology and Cardiovascular Medicine business Cell Adhesion Molecules Biomarkers Niacin

description

High-density-lipoproteins-cholesterol (HDL-C) is invertedly related to the incidence of cardiovascular events. Recent studies suggest that HDL-C directly improves endothelial function. Nicotinic acid (niacin) effectively raises serum HDL-C. We therefore hypothesized that treatment with niacin improves endothelial dysfunction in patients with coronary artery disease (CAD). One hundred seven patients with CAD were randomly assigned to double-blinded treatment for 12 weeks with extended-release (ER)-niacin 1000 mg/day (N) or placebo (C), respectively. Flow-mediated dilation (FMD) of the brachial artery, nitroglycerin-mediated endothelium-independent dilation (NMD) and serum lipid concentrations were measured before and after treatment. Triglycerides (P=0.013), low-density-lipoprotein-cholesterol (LDL-C) (P=0.013) and HDL-C (P<0.0001) were altered by N compared to C. Niacin treatment was without effect on FMD or NMD, respectively, compared to placebo. However, post-hoc subgroup analysis revealed an improvement in FMD in patients with low HDL-C at baseline (absolute change in FMD (mean+/-S.D.) N: +3.25+/-3.88%, C: +1.03+/-2.71% in low tertile HDL-C <or=45 mg/dl. P=0.047). The present findings indicate that ER-niacin treatment improves endothelial dysfunction in patients with CAD and low HDL-C, but not with normal HDL-C.

year	journal	country	edition	language
2009-05-01	Atherosclerosis

https://doi.org/10.1016/j.atherosclerosis.2008.08.003