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Cardiovascular highlights from non-cardiology journals
Niacin fails to prevent cardiovascular events Observational studies have consistently demonstrated that levels of LDL cholesterol directly correlate with cardiovascular risk while HDL levels are inversely related to cardiovascular risk. Niacin is known to reduce LDL levels and concurrently raise HDL levels. In the HPS2-THRIVE study, 25,673 patients with a background of vascular disease were randomized to receive 2 g of extended-release niacin and 40 mg of laropiprant (an anti-flushing agent) or a matching placebo daily. Prior to starting the study, in a run-in phase, background statin therapy was standardized wit...
Source: Heart - September 23, 2014 Category: Cardiology Authors: Bradley, S. M. Tags: Journal scan Source Type: research

PodMed: A Medical News Roundup From Johns Hopkins (with audio)
(MedPage Today) -- This week's topics include stroke and risk, pill color and compliance, telecare for pain management, and niacin for prevention of heart disease.
Source: MedPage Today Cardiovascular - July 18, 2014 Category: Cardiology Source Type: news

Well: 3 Things to Know About Niacin and Heart Health
New studies are adding to concerns about the safety and effectiveness of niacin, a popular drug for the prevention of cardiovascular disease.
Source: NYT - July 17, 2014 Category: American Health Authors: By HARLAN M. KRUMHOLZ, M.D. Tags: Niacin National Institutes of Health Heart Cholesterol Body Stroke Krumholz, Harlan M medicine and health New England Journal of Medicine Statins (Cholesterol-Lowering Drugs) Featured Source Type: news

Relationship of Lipoproteins to Cardiovascular Events The AIM-HIGH Trial (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides and Impact on Global Health Outcomes)
This study sought to examine the relationship between niacin treatment, lipoproteins, and cardiovascular (CV) outcomes in this secondary analysis of the AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides and Impact on Global Health Outcomes) trial.BackgroundDuring a 3-year follow-up in 3,414 patients with established CV disease and low high-density lipoprotein cholesterol (HDL-C) levels, combined niacin + low-density lipoprotein cholesterol (LDL-C)–lowering therapy did not reduce CV events compared with LDL-C–lowering therapy alone.MethodsSubjects taking simvastatin and/or ez...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - October 14, 2013 Category: Cardiology Source Type: research

Extended-Release Niacin Therapy and Risk of Ischemic Stroke in Patients With Cardiovascular Disease: The Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcome (AIM-HIGH) Trial Major Clinical Trials
Conclusions— Although there were numerically more ischemic strokes with addition of ERN to simvastatin that reached nominal significance, the number was small, and multivariable analysis accounting for known risk factors did not support a significant association between niacin and ischemic stroke risk. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00120289.
Source: Stroke - September 23, 2013 Category: Neurology Authors: Teo, K. K., Goldstein, L. B., Chaitman, B. R., Grant, S., Weintraub, W. S., Anderson, D. C., Sila, C. A., Cruz-Flores, S., Padley, R. J., Kostuk, W. J., Boden, W. E., on behalf of the AIM-HIGH Investigators Tags: Secondary prevention, Risk Factors, Acute Cerebral Infarction, Other Stroke Treatment - Medical Major Clinical Trials Source Type: research

Mitochondrial Dysfunction in Migraine
Migraine is the most frequent type of headache in children. In the 1980s, scientists first hypothesized a connection between migraine and mitochondrial (mt) disorders. More recent studies have suggested that at least some subtypes of migraine may be related to a mt defect. Different types of evidence support a relationship between mitochondria (mt) and migraine: (1) Biochemical evidence: Abnormal mt function translates into high intracellular penetration of Ca2+, excessive production of free radicals, and deficient oxidative phosphorylation, which ultimately causes energy failure in neurons and astrocytes, thus triggering ...
Source: Seminars in Pediatric Neurology - September 1, 2013 Category: Neurology Authors: William R. Yorns, H. Huntley Hardison Source Type: research

Relationship of Lipoproteins to Cardiovascular Events: The AIM-HIGH Trial (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides and Impact on Global Health Outcomes)
This study sought to examine the relationship between niacin treatment, lipoproteins, and cardiovascular (CV) outcomes in this secondary analysis of the AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides and Impact on Global Health Outcomes) trial.Background: During a 3-year follow-up in 3,414 patients with established CV disease and low high-density lipoprotein cholesterol (HDL-C) levels, combined niacin + low-density lipoprotein cholesterol (LDL-C)–lowering therapy did not reduce CV events compared with LDL-C–lowering therapy alone.Methods: Subjects taking simvastatin and/o...
Source: Journal of the American College of Cardiology - August 2, 2013 Category: Cardiology Authors: John R. Guyton, April E. Slee, Todd Anderson, Jerome L. Fleg, Ronald B. Goldberg, Moti L. Kashyap, Santica M. Marcovina, Stephen D. Nash, Kevin D. O'Brien, William S. Weintraub, Ping Xu, Xue-Qiao Zhao, William E. Boden Tags: Cardiometabolic Risk Source Type: research

Cardio Notes: Niacin and Stroke Risk
(MedPage Today) -- The correlation of niacin with stroke in the AIM-HIGH trial lost significance when other factors were considered. Also this week, finding vulnerable coronary lesions before they rupture and improving fluoro time.
Source: MedPage Today Cardiovascular - July 29, 2013 Category: Cardiology Source Type: news

Niacin Full Results in HPS2-THRIVE Aired at ACCNiacin Full Results in HPS2-THRIVE Aired at ACC
Regarding the primary end point, the combination of coronary death, nonfatal MI, stroke, or coronary revascularization occurred in 15.0% of patients in the control arm and 14.5% of patients in the niacin/laropiprant arm, a difference that was not statistically significant. Equally important, the researchers also documented a significantly increased risk of adverse events with niacin/laropiprant, w Heartwire
Source: Medscape Today Headlines - March 10, 2013 Category: Consumer Health News Tags: Cardiology News Source Type: news

Trials Of Niacin And Atrial Fibrillation Device Will Headline American College Of Cardiology Program
Two big trials will highlight this year's American College of Cardiology meeting in March in San Francisco. First is the PREVAIL trial testing Boston Scientific's long-anticipated Watchman left atrial appendage closure device for stroke prevention in patients with atrial fibrillation. Second is  the detailed presentation of the controversial failed HPS2-THRIVE trial of extended-release niacin and laropiprant. The final list of trials has been posted on the ACC website.
Source: Forbes.com Healthcare News - January 22, 2013 Category: Pharmaceuticals Authors: Larry Husten Source Type: news

The Current State of Niacin in Cardiovascular Disease Prevention A Systematic Review and Meta-Regression
ConclusionsThe consensus perspective derived from available clinical data supports that niacin reduces CVD events and, further, that this may occur through a mechanism not reflected by changes in high-density lipoprotein cholesterol concentration.
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - January 21, 2013 Category: Cardiology Source Type: research

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