title: MRI-measured regression of carotid atherosclerosis induced by statins with and without niacin in a randomised controlled trial: the NIA plaque study.
abstract: OBJECTIVE
  To evaluate the benefit of niacin in addition to statin therapy on plaque regression among older individuals with established atherosclerosis.
  
  
  METHODS
  Randomised, controlled, double-blind clinical trial.
  
  
  METHODS
  University outpatient center.
  
  
  METHODS
  145 patients older than 65 years, half of them older than 75 years of age, with established atherosclerosis were enrolled.
  
  
  METHODS
  Participants received either extended release niacin (1500 mg daily) or placebo in addition to statin therapy to reach their National Cholesterol Education Program-defined low density lipoprotein (LDL) cholesterol target.
  
  
  METHODS
  The primary endpoint was reduction in the wall volume of the internal carotid artery (ICA) measured by MRI.
  
  
  RESULTS
  After 18 months, high density lipoprotein cholesterol was higher with statins plus niacin compared with statins alone (1.6 ± 0.4 vs 1.4 ± 0.4 mmol/L p<0.001). Both groups had significant decreases in the main outcome measure of ICA wall volume, which regressed at 0.5%/month (SEM 0.2, p=0.004) in the statins plus placebo group and at 0.7%/month in the statins plus niacin group (SEM 0.2, p<0.001). There was no difference in the rate of regression between groups (p=0.49).
  
  
  CONCLUSIONS
  Treatment with statin therapy to presently recommended LDL levels, with or without niacin, resulted in significant atherosclerosis reduction.
authors.affiliation: Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, , Bethesda, Maryland, USA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Sibley
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Vavere
authors.forename: Ilan
authors.initials: I
authors.lastname: Gottlieb
authors.forename: Christopher
authors.initials: C
authors.lastname: Cox
authors.forename: Matthew
authors.initials: M
authors.lastname: Matheson
authors.forename: Amy
authors.initials: A
authors.lastname: Spooner
authors.forename: Gustavo
authors.initials: G
authors.lastname: Godoy
authors.forename: Veronica
authors.initials: V
authors.lastname: Fernandes
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Wasserman
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D009525:Niacin / Q000627:therapeutic use*; D058226:Plaque, Atherosclerotic / Q000175:diagnosis* / Q000188:drug therapy*; D012074:Remission Induction
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D009525:Niacin
keywords: CORONARY ARTERY DISEASE; LIPIDS