Preventive Cardiology Center, Tufts Medical Center, Division of Cardiology, Department of Medicine, 800 Washington Street, Box 80, Boston, MA 02111, USA.
Expert Opin Pharmacother. 2010 Oct;11(14):2291-300. doi: 10.1517/14656566.2010.498818.
The combination use of niacin and HMG Co-A reductases (statins) is increasing. While statin therapy reduces the risk of adverse cardiovascular events, additional therapies are needed to decrease event rates further. High-density lipoprotein cholesterol (HDL-C) is of interest as a potential therapeutic target as epidemiologic evidence demonstrates that low HDL-C is a strong predictor of incident coronary events. Niacin is the most effective agent available at present to increase HDL-C.
This review focuses on the efficacy and safety of niacin in combination with statins, along with the combination's effects on cardiovascular end points and clinical outcomes. We systematically reviewed studies, dating from 2001 to the present, identified through MEDLINE and searches of reference lists, which contained a combination statin and niacin group.
The reader will gain an understanding of the rationale and results of using niacin and statin therapy concurrently.
The addition of niacin to statin therapy results in multiple favorable effects on lipid levels, and the combination seems to be as safe as the individual drugs separately. Current evidence indicates that adding niacin to statin therapy has the potential to result in substantial reductions in risk for adverse cardiovascular events. However, large-scale clinical outcome trials are needed to confirm the benefits of this combination.
烟酸和 HMG Co-A 还原酶（他汀类药物）的联合使用正在增加。虽然他汀类药物治疗降低了不良心血管事件的风险，但需要额外的治疗方法来进一步降低事件发生率。高密度脂蛋白胆固醇（HDL-C）作为一个潜在的治疗靶点引起了关注，因为流行病学证据表明，低 HDL-C 是冠心病事件发生的一个强有力的预测因素。烟酸是目前增加 HDL-C 最有效的药物。
本篇综述重点关注烟酸与他汀类药物联合使用的疗效和安全性，以及该联合用药对心血管终点和临床结果的影响。我们通过 MEDLINE 进行了系统地检索，并查阅了参考文献列表，检索了自 2001 年以来的研究，这些研究包含了他汀类药物和烟酸联合治疗组。
读者将了解同时使用烟酸和他汀类药物治疗的原理和结果。
在他汀类药物治疗的基础上加用烟酸可使血脂水平得到多重改善，且联合用药的安全性似乎与单独使用两种药物一样。目前的证据表明，在他汀类药物治疗的基础上加用烟酸有可能显著降低不良心血管事件的风险。然而，还需要大规模的临床结局试验来证实这种联合用药的益处。
