Niacin, also known as Vitamin B3, taken by mouth in a controlled-release form, caused significant improvement in artery wall thickening, compared to Zetia (ezetimibe). (10.1056/NEJMoa0907569 at NEJM.org, also print NEJM 2009:2113-22.)
Blood lipids were measured and followed during the trial. HDL-C (the good cholesterol) went up significantly with niacin, but down with ezetimibe. Triglycerides went down with niacin. LDL-C (the bad cholesterol) decreased significantly with ezetimibe.
The thickness of the carotid artery walls was reduced to a much greater extent in subjects taking niacin. In some cases, subjects taking ezetimibe, with lower LDL-C, actually had a worsening of the thickening of the artery walls.
Major cardiovascular events (heart attacks, strokes, etc.) happened less frequently in those taking niacin: one percent, while more were seen with ezetimibe: 5%.
Dr. Taylor, the lead author, reports he receives lecture fees from Abbott pharmaceuticals--makers of Niaspan (niacin), a long-acting form of niacin.
Dr. Miller, a co-author, receives lecture fees and grant support from Merck-Schering-Plough Pharmaceuticals, makers of Zetia (ezetimibe).
Dr. Turco, the last listed author of this article, receives consulting and lecture fees from Abbott Cardiovascular.
Comments