<abstract xmlns="http://www.w3.org/1999/xhtml"><p> Niacin was the first hypolipidemic drug to significantly reduce both major cardiovascular events and mortality in patients with cardiovascular disease. Niacin favorably influences all lipoprotein classes, including lipoprotein[a],and belongs to the most potent hypolipidemic drugs for increasing HDL-C. Moreover, niacin causes favorable changes to the qualitative composition of lipoprotein HDL. In addition to its pronounced hypolipidemic action, niacin exerts many other, non-hypolipidemic effects (e.g., antioxidative, anti-inflammatory, antithrombotic), which favorably influence the development and progression of atherosclerosis. These effects are dependent on activation of the specific receptor HCA2. Recent results published by the two large clinical studies, AIM-HIGH and HPS2-THRIVE, have led to the impugnation of niacin’s role in future clinical practice. However, due to several methodological flaws in the AIM-HIGH and HPS2-THRIVE studies, the pleiotropic effects of niacin now deserve thorough evaluation. This review summarizes the present and possible future use of niacin in clinical practice in light of its newly recognized pleiotropic effects.</p></abstract>

Niacin was the first hypolipidemic drug to significantly reduce both major cardiovascular events and mortality in patients with cardiovascular disease. Niacin favorably influences all lipoprotein classes, including lipoprotein[a],and belongs to the most potent hypolipidemic drugs for increasing HDL-C. Moreover, niacin causes favorable changes to the qualitative composition of lipoprotein HDL. In addition to its pronounced hypolipidemic action, niacin exerts many other, non-hypolipidemic effects (e.g., antioxidative, anti-inflammatory, antithrombotic), which favorably influence the development and progression of atherosclerosis. These effects are dependent on activation of the specific receptor HCA2. Recent results published by the two large clinical studies, AIM-HIGH and HPS2-THRIVE, have led to the impugnation of niacin’s role in future clinical practice. However, due to several methodological flaws in the AIM-HIGH and HPS2-THRIVE studies, the pleiotropic effects of niacin now deserve thorough evaluation. This review summarizes the present and possible future use of niacin in clinical practice in light of its newly recognized pleiotropic effects.

Pleiotropic effects of niacin: Current possibilities for its clinical use

4th Department of Medicine, 1st Faculty of Medicine, Charles University in Prague, Prague, Czechia

Institute of Pharmacology, 1st Faculty of MedicineCharles University in Prague, Prague, Czechia

Research and Development Center, C2P s.r.o., Chlumec/n Cidlinou, Czechia

4th Department of Medicine, 1st Faculty of Medicine, Charles University in PraguePrague, Czechia

Institute of Macromolecular, Chemistry, Academy of Sciences of the Czech Republic Prague, Czechia

Acta Pharmaceutica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

{"article-title":"Pleiotropic effects of niacin: Current possibilities for its clinical use"}

Niacin was the first hypolipidemic drug to significantly reduce both major cardiovascular events and mortality in patients with cardiovascular disease. Niacin...

Pleiotropic effects of niacin: Current possibilities for its clinical use

Published Online: Oct 15, 2016

Page range: 449 - 469

Accepted: Jun 02, 2016

DOI: https://doi.org/10.1515/acph-2016-0043

Keywords
niacin, pleiotropic effects, HCA2 receptor, dyslipidemia, cardiovascular mortality/morbidity

© by Miroslav Zeman

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Pleiotropic effects of niacin: Current possibilities for its clinical use

Published Online: Oct 15, 2016

Page range: 449 - 469

Accepted: Jun 02, 2016

DOI: https://doi.org/10.1515/acph-2016-0043

Keywordsniacin, pleiotropic effects, HCA2 receptor, dyslipidemia, cardiovascular mortality/morbidity

© by Miroslav Zeman

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
niacin, pleiotropic effects, HCA2 receptor, dyslipidemia, cardiovascular mortality/morbidity