Document Detail


Effects of oral niacin on endothelial dysfunction in patients with coronary artery disease: results of the randomized, double-blind, placebo-controlled INEF study.
MedLine Citation:
PMID:  18822413     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Ascan Warnholtz; Philipp Wild; Mir Abolfazl Ostad; Veronika Elsner; Fabian Stieber; Reinhard Schinzel; Ulrich Walter; Dirk Peetz; Karl Lackner; Stefan Blankenberg; Thomas Munzel
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-08-12
Journal Detail:
Title:  Atherosclerosis     Volume:  204     ISSN:  1879-1484     ISO Abbreviation:  Atherosclerosis     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-04     Completed Date:  2009-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  216-21     Citation Subset:  IM    
Affiliation:
Department of Medicine II, Johannes Gutenberg-University Mainz, Mainz, Germany. warnholt@uni-mainz.de
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Biological Markers / blood
Blood Glucose / drug effects
Brachial Artery / drug effects*,  physiopathology,  ultrasonography
Cell Adhesion Molecules / blood
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Coronary Artery Disease / blood,  drug therapy*,  physiopathology
Delayed-Action Preparations
Double-Blind Method
Endothelium, Vascular / drug effects*,  physiopathology
Female
Humans
Male
Microfilament Proteins / blood
Middle Aged
Niacin / administration & dosage*
Nitroglycerin / administration & dosage
Phosphoproteins / blood
Phosphorylation
Prospective Studies
Treatment Outcome
Triglycerides / blood
Vasodilation / drug effects*
Vasodilator Agents / administration & dosage*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Blood Glucose; 0/Cell Adhesion Molecules; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Delayed-Action Preparations; 0/Microfilament Proteins; 0/Phosphoproteins; 0/Triglycerides; 0/Vasodilator Agents; 0/vasodilator-stimulated phosphoprotein; 55-63-0/Nitroglycerin; 59-67-6/Niacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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