Division of Cardiology, Rush University Medical Center, Chicago, IL, USA -
Institute of Cardiovascular Research and Technology, Brooklyn, NY, USA -
Minerva Med. 2019 Feb;110(1):79-83. doi: 10.23736/S0026-4806.18.05826-3. Epub 2018 Oct 11.
Despite significant risk reduction with statin therapy, there remains a residual cardiovascular risk. It has been seen that aggressive statin therapy in high risk patients may not lower the low-density lipoprotein cholesterol to goal in up to 40% of patients. Niacin is a potent high-density lipoprotein cholesterol-raising drug, and has been proposed as an attractive approach to reduce cardiac events in patients with or at risk of atherosclerotic cardiovascular disease. However, previous evidence for niacin has been challenged by negative outcomes in two large, randomized, controlled trials comparing niacin to placebo with background statin therapy. In this review, summarize the currently available evidence for the role of niacin treatment for reducing the risk of cardiovascular events in current practice.
尽管他汀类药物治疗显著降低了风险，但仍存在残余心血管风险。已经发现，在高危患者中进行强化他汀类药物治疗，多达 40%的患者可能无法将低密度脂蛋白胆固醇降至目标水平。烟酸是一种强效的高密度脂蛋白胆固醇升高药物，被认为是降低动脉粥样硬化性心血管疾病患者或有风险患者心脏事件的一种有吸引力的方法。然而，烟酸的先前证据受到两项大型随机对照试验的负面影响的挑战，这些试验将烟酸与安慰剂联合背景他汀类药物治疗进行了比较。在这篇综述中，总结了目前可用的证据，说明烟酸治疗在当前实践中降低心血管事件风险的作用。
