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  • Effects of niacin combination therapy with statin or bile acid resin on lipoproteins and cardiovascular disease.

Effects of niacin combination therapy with statin or bile acid resin on lipoproteins and cardiovascular disease.

The American journal of cardiology (2014-03-20)
Alberto Zambon, Xue-Qiao Zhao, B Greg Brown, John D Brunzell
ABSTRACT

Two large studies in populations selected for cardiovascular disease (CVD) demonstrated that raising high-density lipoprotein (HDL) cholesterol with niacin added to statin therapy did not decrease CVD. We examine the association of lipoprotein subfractions with niacin and changes in coronary stenosis and CVD event risk. One hundred and seven patients from 2 previous studies using niacin in combination with either statin or bile acid-binding resin were selected to evaluate changes in lipoproteins separated by density-gradient ultracentrifugation to progression of coronary artery disease as assessed by quantitative coronary angiography. Improvement in coronary stenosis was significantly associated with the decrease of cholesterol in the dense low-density lipoprotein (LDL) particles and across most of the intermediate density lipoprotein (IDL) and very low density lipoprotein particle density range, but, not with any of the HDL fraction or of the more buoyant LDL fractions. Event-free survival was significantly associated with the decrease of cholesterol in the dense LDL and IDL; there was no association with changes in cholesterol in the HDL and buoyant LDL fractions. Niacin combination therapy raises HDL cholesterol and decreases dense LDL and IDL cholesterol levels. Changes in LDL and IDL are related to improvement in CVD. Lipoprotein subfraction analysis should be performed in larger studies utilizing niacin in combination with statins.

MATERIALS
Product Number
Brand
Product Description

Nicotinic acid, European Pharmacopoeia (EP) Reference Standard
Supelco
Nicotinic acid, analytical standard
Supelco
Niacin (Nicotinic Acid), Pharmaceutical Secondary Standard; Certified Reference Material
Sigma-Aldrich
Nicotinic acid, BioReagent, suitable for cell culture, suitable for insect cell culture, suitable for plant cell culture, ≥98%
Sigma-Aldrich
Nicotinic acid, ≥98%
Sigma-Aldrich
Nicotinic acid, meets USP testing specifications
Sigma-Aldrich
Nicotinic acid sodium salt, 98%
Sigma-Aldrich
Nicotinic acid, ≥99.5% (HPLC)
USP
Niacin, United States Pharmacopeia (USP) Reference Standard