title: A pilot trial to examine the effect of high-dose niacin on arterial wall inflammation using fluorodeoxyglucose positron emission tomography.
abstract: OBJECTIVE
  Although studies have reported direct inhibition of inflammatory pathways with niacin, the effect of niacin on arterial wall inflammation remains unknown. We examined the effect of niacin on arterial (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT).
  
  
  METHODS
  Nine statin-treated patients with coronary disease were randomized to niacin 6000 mg/day or placebo. FDG-PET/CT and lipids were assessed at baseline and at 12 weeks. FDG was quantified in the aorta, right carotid artery, and left carotid artery as the target-to-background ratio (TBR) and target-to-background difference (TBD).
  
  
  RESULTS
  Eight patients completed the study. No significant changes in FDG measured by aortic, left carotid, or right carotid TBR or TBD were seen in either group. Compared to baseline, niacin-treated subjects exhibited a significant 29% reduction in low-density lipoprotein cholesterol (LDL-C; 95% confidence interval [CI], -50% to 8%; P = .01) and a nonsignificant 29% reduction in LDL particle number (LDL-P; 95% CI, -58% to 0.2%; P = .07). A nonsignificant 11% increase in HDL-C (95% CI, -15% to 37%; P = .30) and 8% decrease in HDL-P (95% CI, -44% to 28%; P = .51) were observed with niacin treatment. In a pooled analysis, changes in LDL-P were positively correlated with FDG uptake in the aorta (TBR r = 0.66, P = .08; TBD r = 0.75, P = .03), left carotid (TBR r = 0.65, P = .08; TBD r = 0.74, P = .03), and right carotid (TBR r = 0.54, P = .17; TBD r = 0.61, P = .11).
  
  
  CONCLUSIONS
  In this pilot study, adding niacin to statin therapy did not affect arterial wall inflammation measured by FDG-PET/CT. However, an association between changes in arterial FDG uptake and LDL-P was observed. Larger studies are needed to definitively examine the effect of niacin on arterial wall inflammation.
authors.affiliation: Division of Cardiovascular Medicine, Perelman Center for Advanced Medicine, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104. Electronic address: Emil.deGoma@uphs.upenn.edu.
authors.forename: Emil M
authors.initials: EM
authors.lastname: deGoma
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Ali
authors.initials: A
authors.lastname: Salavati
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Russell T
authors.initials: RT
authors.lastname: Shinohara
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Babak
authors.initials: B
authors.lastname: Saboury
authors.affiliation: Division of Translational Medicine and Human Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Laura
authors.initials: L
authors.lastname: Pollan
authors.affiliation: Division of Translational Medicine and Human Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Marisa
authors.initials: M
authors.lastname: Schoen
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Drew A
authors.initials: DA
authors.lastname: Torigian
authors.affiliation: Division of Cardiovascular Medicine, Perelman Center for Advanced Medicine, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104.
authors.forename: Emile R
authors.initials: ER
authors.lastname: Mohler
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Dunbar
authors.affiliation: Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Harold I
authors.initials: HI
authors.lastname: Litt
authors.affiliation: Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: John
authors.initials: J
authors.lastname: Woo
authors.affiliation: Division of Translational Medicine and Human Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Rader
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Abass
authors.initials: A
authors.lastname: Alavi
authors.affiliation: Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute.
authors.forename: Nehal N
authors.initials: NN
authors.lastname: Mehta
mesh_terms: D001011:Aorta / Q000000981:diagnostic imaging; D001241:Aspirin / Q000008:administration & dosage; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D004311:Double-Blind Method; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D007249:Inflammation / Q000000981:diagnostic imaging / Q000188:drug therapy; D008055:Lipids / Q000097:blood; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D064847:Multimodal Imaging; D009525:Niacin / Q000008:administration & dosage*; D010865:Pilot Projects; D010919:Placebos; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D000960:Hypolipidemic Agents; D008055:Lipids; D010919:Placebos; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D009525:Niacin; D001241:Aspirin
keywords: Atherosclerosis; fluorodeoxyglucose; lipids; niacin; positron emission tomography