The Use Of Nicotinic Acid In The Treatment Of Heart Disease

The Use Of Nicotinic Acid In The Treatment Of Heart Disease.
Combining the vitamin niacin with a cholesterol-lowering statin analgesic appears to put forward patients no aid and may also increase side effects, a new study indicates. It's a insufficient result from the largest-ever study of niacin for heart patients, which involved almost 26000 people. In the study, patients who added the B-vitamin to the statin narcotic Zocor saw no added help in terms of reductions in heart-related death, non-fatal heart attack, stroke, or the need for angioplasty or sidestep surgeries.

The study also found that people taking niacin had more incidents of bleeding and (or) infections than those who were taking an motionless placebo, according to a team reporting Saturday at the annual meeting of the American College of Cardiology, in San Francisco. "We are disheartened that these results did not show benefits for our patients," study lead author Jane Armitage, a professor at the University of Oxford in England, said in a engagement news release. "Niacin has been worn for many years in the belief that it would help patients and prevent heart attacks and stroke, but we now be informed that its adverse side effects outweigh the benefits when used with current treatments".

Niacin has long been hand-me-down to boost levels of "good" HDL cholesterol and decrease levels of "bad" LDL cholesterol and triglycerides (fats) in the blood in hoi polloi at risk for heart disease and stroke. However, niacin also causes a mass of side effects, including flushing of the skin. A drug called laropiprant can reset the incidence of flushing in people taking niacin. This new study included patients with narrowing of the arteries.

They received either 2 grams of extended-release niacin addition 40 milligrams of laropiprant or like placebos. All of the patients also took Zocor (simvastatin). The patients from China, the United Kingdom and Scandinavia were followed for an typical of almost four years.

Besides showing no profitable effect on heart health outcomes, the team noted that people taking niacin had about the same amount of heart-related events (13,2 percent) as those who took a placebo a substitute (13,7 percent). Side things were common. As already reported online Feb 26, 2013 in the European Heart Journal, by the end of the study, 25 percent of patients taking niacin with an increment of laropiprant had stopped their treatment, compared with 17 percent of the patients taking a placebo.

And "The outstanding reason for patients stopping the care was because of adverse side effects, such as itching, rashes, flushing, indigestion, diarrhea, diabetes and muscle problems," Armitage said at the spell in a journal news release. "We found that patients allocated to the hypothetical treatment were four times more likely to stop for skin-related reasons, and twice as odds-on to stop because of gastrointestinal problems or diabetes-related problems". Patients taking niacin and laropiprant had a more than fourfold increased peril of muscle pain or weakness compared to the placebo group, the team noted.

Did the liability lie with the laropiprant and not niacin? Armitage is doubtful. She pointed to a prior trial, called AIM-HIGH, which was discontinued antiquated in 2011 when researchers found no benefit to niacin treatment. At the time, some experts said that the smaller residents in AIM-HIGH masked any sign of benefit, but Armitage said the unknown trial's much bigger study group confirms that niacin probably does not help.

Speaking in February 2013 at the duration of the journal's release of niacin's safety profile, one US expert was less than impressed by niacin's performance. The trouble "confirms that, for the present moment, there may be little additional service with the use of niacin when patients are well treated with the lipid-lowering statin drugs," said Dr Kevin Marzo, principal of cardiology at Winthrop-University Hospital in Mineola, NY. He said that the results of the redesigned trial, along with those from a prior large study, "now may put the final nail in the coffin on niacin-based strategies to gather HDL and lower cardiovascular events".

Other tried-and-true approaches may work best. "In adding up to statins, our focus should be on continued lifestyle changes such as a Mediterranean diet, complemented with day after day exercise". The US Food and Drug Administration had been waiting on the new provisional results to decide whether to approve niacin/laropiprant for use against heart disease body ko fit rakhne ke tips. But in December 2012, responding to premonitory findings, drug maker Merck said it no longer planned to press for affirmation from the FDA and in January 2013 delayed niacin/laropiprant from markets worldwide.