Indicated to REDUCE the risk of recurrent, nonfatal MI1
In patients with a history of myocardial infarction (MI) and hypercholesterolemia, niacin is indicated to REDUCE the risk of recurrent, non-fatal MI1
The primary objective was to test the efficacy and safety of several lipid-influencing drugs in the long-term therapy of CHD in men (aged 30-64 years) with proven previous MI. The 53 project clinical centers recruited 8341 patients who were randomly assigned to the 6 treatment groups. In patients receiving niacin 3 g/day (n=1119) vs. patients receiving lactose placebo 3.8 g/day (n=2789), total mortality was similar between the two groups at 5 years (p=NS).
Results of the Coronary Drug Project study at 5 years demonstrated that men with proven previous MI who received daily niacin:2
- Experienced a significant 27% reduction in the incidence of nonfatal MI vs. placebo.
Nonfatal MI occurred in 8.9% of men taking niacin, vs. 12.2% of men taking placebo (p<0.004).2 The primary objective was to test the efficacy and safety of several lipid-influencing drugs in the long-term therapy of CHD in men (aged 30-64 years) with proven previous MI. The 53 project clinical centers recruited 8341 patients who were randomly assigned to the 6 treatment groups. In patients receiving niacin 3 g/day (n=1119) vs. patients receiving lactose placebo 3.8 g/day (n=2789), total mortality was similar between the two groups at 5 years (p=NS).
Nonfatal MI occurred in 8.9% of men taking niacin, vs. 12.2% of men taking placebo (p<0.004)2
Results from the Familial Atherosclerosis Treatment Study (FATS)1,3
Results obtained from a randomized, double-blind, placebo-controlled trial of 146 men <62 years of age with elevated apolipoprotein B levels (Apo B>125 mg/dL), a family history of CAD, and evidence of coronary atherosclerosis. After receiving dietary counseling, patients were randomly assigned to treatment with niacin/colestipol, lovastatin/colestipol, or conventional therapy.
*Conventional therapy consisted of placebos for colestipol/lovastatin, unless their baseline LDL-C level exceeded the 90th percentile for age — those patients received colestipol instead of placebo.
Results from the Familial Atherosclerosis Treatment Study (FATS), demonstrated that:1,3
- 39% of patients taking niacin + colestipol, with dietary counseling, experienced significant regression from baseline (p<0.005 vs. placebo)
- 25% of patients taking niacin + colestipol experienced progression
- Though not an original endpoint of the trial, clinical events (death, MI, or revascularization for worsening angina) occurred in 10 of 52 patients who received conventional therapy compared with 2 of 48 who received niacin + colestipol.
Next: Dosing and Titration
References
1. NIASPAN® prescribing information. North Chicago, IL; Abbott Laboratories.
2. The Coronary Drug Project Research Group. Clofibrate and niacin in coronary heart disease. JAMA. 1975;231:360-381.
3. Brown G, Albers JJ, Fisher LD, et al. Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B. N Engl J Med. 1990;323:1289-1298.
