Effect of niacin therapy on cardiovascular outcomes in patients with coronary artery disease

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#cardiovascular-diseases #coronary-artery-disease #humans #hypolipidemic-agents #myocardial-infarction

Effect of niacin therapy on cardiovascular outcomes in patients with coronary artery disease

Duggal et al., 2010 | J Cardiovasc Pharmacol Ther | Meta Analysis

Citation

Duggal Jasleen K, Singh Mukesh, ... Arora Rohit. Effect of niacin therapy on cardiovascular outcomes in patients with coronary artery disease. J Cardiovasc Pharmacol Ther. 2010-Jun;15(2):158-66. doi:10.1177/1074248410361337

Abstract

BACKGROUND: Niacin or nicotinic acid (vitamin B3) raises the levels of high-density lipoprotein cholesterol (HDL) by about 30% to 35%. In patients with prior coronary disease, 7 trials have been published on clinical cardiovascular disease outcomes and the results, not surprisingly, are inconsistent. Hence, we performed this meta-analysis of randomized placebo-controlled trials (RCTs) to evaluate the effect of niacin on cardiovascular outcomes in patients with coronary artery disease. METHODS: A systematic search using PubMed, EMBASE, and Cochrane library databases was performed. Seven studies with a total of 5137 patients met our inclusion criteria. Heterogeneity of the studies was analyzed by the Cochran Q statistics. The significance of common treatment effect was assessed by computing the combined relative risks using the Mantel-Haenszel fixed-effect model. A 2-sided alpha error of less than .05 was considered statistically significant (P < .05). RESULTS: Compared to placebo group, niacin therapy significantly reduced coronary artery revascularization (RR [relative risk]: 0.307 with 95% CI: 0.150-0.628; P = .001), nonfatal myocardial infarction ([MI]; RR: 0.719; 95% CI: 0.603-0.856; P = .000), stroke, and TIA ([transient ischemic attack] RR: 0.759; 95%CI: 0.613-0.940; P = .012), as well as a possible but nonsignificant decrease in cardiac mortality (RR: 0.883: 95% CI: 0.773-1.008; p= 0.066). CONCLUSIONS: In a meta-analysis of seven trials of secondary prevention, niacin was associated with a significant reduction in cardiovascular events and possible small but non-significant decreases in coronary and cardiovascular mortality.

Key Findings

Compared to placebo group, niacin therapy significantly reduced coronary artery revascularization (RR [relative risk]: 0.307 with 95% CI: 0.150-0.628; P = .001), nonfatal myocardial infarction ([MI]; RR: 0.719; 95% CI: 0.603-0.856; P = .000), stroke, and TIA ([transient ischemic attack] RR: 0.759; 95%CI: 0.613-0.940; P = .012), as well as a possible but nonsignificant decrease in cardiac mortality (RR: 0.883: 95% CI: 0.773-1.008; p= 0.066).

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population prior coronary disease
Sample Size 5137
Age Range See abstract
Condition See abstract

MeSH Terms

  • Cardiovascular Diseases
  • Coronary Artery Disease
  • Humans
  • Hypolipidemic Agents
  • Myocardial Infarction
  • Myocardial Revascularization
  • Niacin
  • Randomized Controlled Trials as Topic

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis
  • Vertical: niacin-cholesterol

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09