Niacin and lipoprotein(a): facts, uncertainties, and clinical considerations.
Over the years, niacin has gained recognition as an atheroprotective agent, in part because of its capacity to lower the plasma levels of cholesterol, triglycerides, and very-low- and low-density lipoproteins and to substantially raise high-density lipoprotein. In high doses, niacin has also been reported to lower the plasma level of lipoprotein(a) (Lp[a]). However, the published research on the subject suffers from a lack of uniformity regarding patient selection, drug dose, length of administration, and methods for plasma Lp(a) quantification. In this report, the authors examine the most relevant niacin-related Lp(a) studies and hypothetical mechanisms of drug action, also considering the emerging notion of Lp(a) as a potential proinflammatory entity.
Scanu
Angelo M
AM
Department of Medicine, University of Chicago, Chicago, Illinois 60637, USA. ascanu@medicine.bsd.uchicago.edu
Bamba
Ravi
R
D000924:Anticholesteremic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D050171:Dyslipidemias / Q000188:drug therapy*; D006801:Humans; D015228:Hypertriglyceridemia / Q000188:drug therapy; D017270:Lipoprotein(a) / Q000097:blood / Q000187:drug effects*; D009525:Niacin / Q000494:pharmacology / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood
D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D017270:Lipoprotein(a); D014280:Triglycerides; D009525:Niacin