Featured Research

from universities, journals, and other organizations

New research shows that while niacin added to statin therapy increases HDL cholesterol levels it does not improve HDL functionality

Date:
March 10, 2013
Source:
Perelman School of Medicine at the University of Pennsylvania
Summary:
While two large clinical trials recently showed that adding niacin to statin therapy failed to improve clinical outcomes despite a significant increase in HDL-C levels, little is known about exactly why the increased HDL-C levels did not reduce the risk of cardiovascular events, including heart attack and stroke. Now, a small study has shown that while niacin increased measured levels of HDL-C, it did not improve the functionality of HDL. This may provide an explanation for the failure of niacin to further reduce cardiovascular risk.

While two large clinical trials recently showed that adding niacin to statin therapy failed to improve clinical outcomes despite a significant increase in HDL-C levels, little is known about exactly why the increased HDL-C levels did not reduce the risk of cardiovascular events, including heart attack and stroke. Now, a small study from researchers the Perelman School of Medicine at the University of Pennsylvania, has shown that while niacin increased measured levels of HDL-C, it did not improve the functionality of HDL. This may provide an explanation for the failure of niacin to further reduce cardiovascular risk.

Related Articles


The study results were reported today at the 62nd Annual Scientific Session of the American College of Cardiology in San Francisco.

"There is a major need to identify additional agents to target residual cardiovascular risk beyond the use of statins," said senior study author Daniel J. Rader, MD, professor of Medicine and chief, Division of Translational Medicine and Human Genetics, at Penn. "Niacin is one of the oldest players in this field and is often used clinically to increase HDL cholesterol levels. However, much to the disappointment of the medical community, recent trials of niacin added to standard LDL-lowering therapy with statins failed to show benefit in improving cardiovascular outcomes. There has been substantial recent interest in the function of HDL independent of HDL cholesterol levels. We performed a small trial to examine how niacin modulated a classic function of HDL, namely its ability to promote cholesterol removal from cells."

Previous work from Penn investigators has shown that a measure of HDL function, cholesterol efflux capacity, is more strongly related to coronary artery disease than HDL cholesterol levels.

To assess the change in functional capacity of HDL with niacin therapy, they randomized 39 patients with known carotid atherosclerosis to either simvastatin plus placebo or simvastatin plus extended-release niacin. After six months of therapy, they measured HDL-C levels and assessed functional properties using two tests -- cholesterol efflux capacity (a measure of how well HDL removes cholesterol from lipid-loaded cells) and the HDL inflammatory index (which quantifies the antioxidant properties as it relates to preventing the oxidation of LDL).

As expected, they saw a 29 percent increase in HDL cholesterol with the addition of niacin to statin therapy, compared to a two percent increase in those treated with statin only. However, on the measures of cholesterol efflux capacity and the HDL inflammatory index, they saw no significant changes in HDL function.

"Based on our research, we now know that the addition of niacin to statin does not improve HDL function, providing a possible explanation for the failure of previous large scale trials," said lead study author Amit Khera, MD, a former member of the Rader lab who is now completing his residency at the Brigham and Women's Hospital. "The assays we used to measure HDL function are robust and reproducible, thus potentially useful in the early clinical screening of new HDL-targeted therapies to understand how/if they might work."

Other study authors from Penn include Parin J. Patel, MD, and Muredach P. Reilly, MBBCH, MSC.

Investigator-initiated grants were received from Merck and KOS (now Abbott) Pharmaceuticals for the study, though they had no influence on study design, analysis, or abstract preparation. The research team also received support from the Penn Cardiovascular Institute and the NIH-CTSA supported Penn Clinical and Translational Research Center (CTRC).


Story Source:

The above story is based on materials provided by Perelman School of Medicine at the University of Pennsylvania. Note: Materials may be edited for content and length.


Cite This Page:

Perelman School of Medicine at the University of Pennsylvania. "New research shows that while niacin added to statin therapy increases HDL cholesterol levels it does not improve HDL functionality." ScienceDaily. ScienceDaily, 10 March 2013. <www.sciencedaily.com/releases/2013/03/130310163802.htm>.
Perelman School of Medicine at the University of Pennsylvania. (2013, March 10). New research shows that while niacin added to statin therapy increases HDL cholesterol levels it does not improve HDL functionality. ScienceDaily. Retrieved November 1, 2014 from www.sciencedaily.com/releases/2013/03/130310163802.htm
Perelman School of Medicine at the University of Pennsylvania. "New research shows that while niacin added to statin therapy increases HDL cholesterol levels it does not improve HDL functionality." ScienceDaily. www.sciencedaily.com/releases/2013/03/130310163802.htm (accessed November 1, 2014).

Share This



More Health & Medicine News

Saturday, November 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Melafind: Spotting Melanoma Without a Biopsy

Melafind: Spotting Melanoma Without a Biopsy

Ivanhoe (Oct. 31, 2014) The MelaFind device is a pain-free way to check suspicious moles for melanoma, without the need for a biopsy. Video provided by Ivanhoe
Powered by NewsLook.com
Battling Multiple Myeloma

Battling Multiple Myeloma

Ivanhoe (Oct. 31, 2014) The answer isn’t always found in new drugs – repurposing an ‘old’ drug that could mean better multiple myeloma treatment, and hope. Video provided by Ivanhoe
Powered by NewsLook.com
Chronic Inflammation and Prostate Cancer

Chronic Inflammation and Prostate Cancer

Ivanhoe (Oct. 31, 2014) New information that is linking chronic inflammation in the prostate and prostate cancer, which may help doctors and patients prevent cancer in the future. Video provided by Ivanhoe
Powered by NewsLook.com
Sickle Cell: Stopping Kids’ Silent Strokes

Sickle Cell: Stopping Kids’ Silent Strokes

Ivanhoe (Oct. 31, 2014) Blood transfusions are proving crucial to young sickle cell patients by helping prevent strokes, even when there is no outward sign of brain injury. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins