The Effects of Niacin on Inflammation in Patients with Non-ST Elevated Acute Coronary Syndrome.
BACKGROUND
In this study, we aimed to evaluate the effects of niacin on high sensitivity C reactive protein (hs-CRP) and cholesterol levels in non-ST elevated acute coronary syndrome (NSTE-ACS) patients.


METHODS
In this prospective, open label study, 48 NSTE-ACS were randomized to niacin or control group. Patients continued their optimal medical therapy in the control group. In the niacin group patients were assigned to receive extended-release niacin 500 mg/day. Patients were contacted 1 month later to assess compliance and side effects. Blood samples for hs-CRP were obtained upon admittance to the coronary care unit, in the third day and in the first month of the treatment. Fasting blood samples for cholesterol levels were obtained before and 30 days after the treatment. The primary end point of the study was to evaluate changes in hs-CRP, cholesterol levels, short-term cardiovascular events, and the safety of niacin in NSTE-ACS.


RESULTS
Baseline demographic, clinical and laboratory characteristics were similar between the two groups. Logarithmic transformation of baseline and 3(rd) day hs-CRP levels were similar between the groups; but 1 month later, logarithmic transformation of hs-CRP level was significantly lower in the niacin group (0.43 ± 0.39 to 0.83 ± 0.91, p = 0.04). HDL-C level was significantly increased in the niacin group during follow-up. Drug related side effects were seen in 7 patients in the niacin group but no patients discontinued niacin.


CONCLUSIONS
Our findings demonstrate that lower dose extended release niacin can be used safely and decreases hs-CRP and lipid parameters successfully in NSTE-ACS patients.


BACKGROUND
Acute coronary syndrome; hs-CRP; Inflammation; Niacin.
Department of Cardiology;
Emir
E
Karacaglar
Department of Cardiology;
Ilyas
I
Atar
Department of Cardiology;
Cihan
C
Altin
Department of Cardiology;
Begum
B
Yetis
Department of Cardiology;
Abdulkadir
A
Cakmak
Department of Biochemistry, Baskent University School of Medicine, Ankara, Turkey.
Nilufer
N
Bayraktar
Department of Cardiology;
Ali
A
Coner
Department of Biochemistry, Baskent University School of Medicine, Ankara, Turkey.
Bulent
B
Ozin
Department of Cardiology;
Haldun
H
Muderrisoglu