Effect of niacin on atherosclerotic cardiovascular disease

Niacin has been studied in 6 major clinical trials with cardiovascular endp oints. The Coronary Drug Project (CDP) was the largest of these trials and the only one to use niacin monotherapy affecting cardiovascular outcomes: r ecurrent myocardial infarction and cerebrovascular events were significantl y decreased. After long-tern (15 years) follow-up, total mortality was also found to be decreased. The of her 5 trials used varying combinations of ni acin with other pharmacologic agents, examining coronary and total mortalit y, coronary events, and angiographic progression/regression. Significant be nefit was Found in all trials except for one in patients with normal choles terol levels at entry. Thus, the use of niacin to prevent or treat atherosc lerotic cardiovascular disease is based on strong and consistent evidence f rom clinical trials. (C) 1998 by Excerpta Medica, Inc.