Hypertriglyceridemia niacin: Difference between revisions

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Overview
Classification Familial hyperchylomicronemia Familial hypercholesterolemia Familial combined hyperlipidemia Dysbetalipoproteinemia Primary hypertriglyceridemia Mixed hyperlipoproteinemia
Differential Diagnosis
Screening
ACC/AHA Guideline Recommendations
Summary
Treatment
Major recommendations for statin therapy
Therapeutic response to statin therapy
Blood cholesterol LDL and non-HDL treatment goals
Treatment in heart failure and hemodialysis
Primary prevention
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Intensity of statin therapy in primary and secondary prevention
Safety Recommendations
Guideline on Lifestyle Management

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Latest revision as of 19:59, 23 November 2016

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For full Niacin drug information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]

Overview

Treatment of hypertriglyceridemia is by restriction of carbohydrates and fat in the diet, as well as with niacin, fibrates and statins (three classes of drugs). Increased fish oil intake may substantially lower an individual's triglycerides.^[1]^[2]^[3].

Supportive Trial Data

Study name	Source & year	Study question	Study Design	Study Population	Time period	Intervention	Results	Conclusions
The Coronary Drug Project ^[4]	J Am Coll Cardiol, 1986	Assess the long-term efficacy and safety of five lipid-influencing drugs	RCT	8,341 men aged 30 to 64 years with h/o ECG confirmed myocardial infarction	1966 and 1975	five lipid-influencing drugs	15% reduction in the risk of MI among men with hypercholesterolemia and decreased total mortality by 10% at 15 years of follow up	Favorable effect of niacin in decreasing non-fatal reinfarction (late benefit)
Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol (ARBITER) 2 ^[5]	Circulation, 2004	Assess the long-term efficacy and safety of five lipid-influencing drugs	Double-blind randomized placebo-controlled study	167 patients (mean age 67 years), h/o coronary heart disease, low HDL(<45 mg/dL)	1 year	Once-daily extended-release niacin (1000 mg) added to background statin therapy	Increase in HDL-C by 21% and unchanged mean CIMT in the niacin group after 12 months	Decreases progression of carotid artery disease in patients with atherosclerosis and statin therapy

References

↑ "Lipids Online Slides: hypertriglyceridemia, ICAM-1, fish oil, E-selectin".
↑ Terres W, Beil U, Reimann B, Tiede S, Bleifeld W (1991). "[Low-dose fish oil in primary hypertriglyceridemia. A randomized placebo-controlled study]". Zeitschrift für Kardiologie (in German). 80 (1): 20–4. PMID 2035283.
↑ "Fish oils in hypertriglyceridemia - Fish Oils Revisited Nutrition Research Newsletter - Find Articles".
↑ Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ; et al. (1986). "Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin". J Am Coll Cardiol. 8 (6): 1245–55. PMID 3782631.
↑ Taylor AJ, Sullenberger LE, Lee HJ, Lee JK, Grace KA (2004). "Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol (ARBITER) 2: a double-blind, placebo-controlled study of extended-release niacin on atherosclerosis progression in secondary prevention patients treated with statins". Circulation. 110 (23): 3512–7. doi:10.1161/01.CIR.0000148955.19792.8D. PMID 15537681.

Template:WikiDoc Sources

[1] "Lipids Online Slides: hypertriglyceridemia, ICAM-1, fish oil, E-selectin".

[pmid2035283-2] Terres W, Beil U, Reimann B, Tiede S, Bleifeld W (1991). "[Low-dose fish oil in primary hypertriglyceridemia. A randomized placebo-controlled study]". Zeitschrift für Kardiologie (in German). 80 (1): 20–4. PMID 2035283.

[3] "Fish oils in hypertriglyceridemia - Fish Oils Revisited Nutrition Research Newsletter - Find Articles".

[pmid3782631-4] Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ; et al. (1986). "Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin". J Am Coll Cardiol. 8 (6): 1245–55. PMID 3782631.

[pmid15537681-5] Taylor AJ, Sullenberger LE, Lee HJ, Lee JK, Grace KA (2004). "Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol (ARBITER) 2: a double-blind, placebo-controlled study of extended-release niacin on atherosclerosis progression in secondary prevention patients treated with statins". Circulation. 110 (23): 3512–7. doi:10.1161/01.CIR.0000148955.19792.8D. PMID 15537681.

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@@ Line 1: / Line 1: @@
-{{Hypertriglyceridemia}}
+__NOTOC__
+{{Hyperlipoproteinemia}}}
 '''For full Niacin drug information click [[Niacin|here]]'''
-{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh@perfuse.org]
+{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com]
 ==Overview==
 Treatment of hypertriglyceridemia is by restriction of carbohydrates and fat in the [[diet (nutrition)|diet]], as well as with [[niacin]], [[fibrate]]s and [[statin]]s (three classes of drugs).  Increased [[fish oil]] intake may substantially lower an individual's triglycerides.<ref>{{cite web |url=http://www.lipidsonline.org/slides/slide01.cfm?q=hypertriglyceridemia&dpg=13 |title=Lipids Online Slides: hypertriglyceridemia, ICAM-1, fish oil, E-selectin | format= |work=}}</ref><ref name="pmid2035283">{{cite journal |author=Terres W, Beil U, Reimann B, Tiede S, Bleifeld W |title=[Low-dose fish oil in primary hypertriglyceridemia. A randomized placebo-controlled study] |language=German |journal=Zeitschrift für Kardiologie |volume=80 |issue=1 |pages=20-4 |year=1991 |pmid=2035283 |doi=}}</ref><ref>{{cite web |url=http://www.findarticles.com/p/articles/mi_m0887/is_n4_v9/ai_8960077 |title=Fish oils in hypertriglyceridemia - Fish Oils Revisited Nutrition Research Newsletter - Find Articles |format= |work=}}</ref>.
-==Niacin/Nicotinic acid==
+===Supportive Trial Data===
-===Mechanism of benefit===
-* Reduces the level of [[low density lipoprotein]] (LDL) (17-26%)<ref name="pmid17804845">{{cite journal| author=Brunzell JD| title=Clinical practice. Hypertriglyceridemia. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 10 | pages= 1009-17 | pmid=17804845 | doi=10.1056/NEJMcp070061 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17804845  }} </ref>
-* Increases  the level of [[high density lipoprotein]] (HDL)
-===Dosage===
-.5 - 2 gm once daily
-===Advantages===
+{|border="1" align="center" style="background:lightskyblue"
-* [[Statin]] alone or combination therapy of niacin with statin are usually the first options used in patients with increased risk of [[premature coronary artery disease]].
+|-
-* Decreases the progression of [[atherosclerosis]] in [[hypertriglyceridemia]] patients.
+| bgcolor="CadetBlue" |'''Study name'''
+| bgcolor="CadetBlue" |'''Source & year'''
+| bgcolor="CadetBlue" |'''Study question'''
+| bgcolor="CadetBlue" |'''Study Design'''
+| bgcolor="CadetBlue" |'''Study Population'''
+| bgcolor="CadetBlue" |'''Time period'''
+| bgcolor="CadetBlue" |'''Intervention'''
+| bgcolor="CadetBlue" |'''Results'''
+| bgcolor="CadetBlue" |'''Conclusions'''
+|-
+| The Coronary Drug Project <ref name="pmid3782631">{{cite journal| author=Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ et al.| title=Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. | journal=J Am Coll Cardiol | year= 1986 | volume= 8 | issue= 6 | pages= 1245-55 | pmid=3782631 | doi= | pmc= | url= }} </ref>
+| J Am Coll Cardiol, 1986
+| Assess the long-term efficacy and safety of five lipid-influencing drugs
+| RCT
+| 8,341 men aged 30 to 64 years with h/o ECG confirmed myocardial infarction
+| 1966 and 1975
+| five lipid-influencing drugs
+| 15% reduction in the risk of MI among men with hypercholesterolemia and decreased total mortality by 10% at 15 years of follow up
+| Favorable effect of niacin in decreasing non-fatal reinfarction (late benefit)
+|-
+|-
+| Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol (ARBITER) 2 <ref name="pmid15537681">{{cite journal| author=Taylor AJ, Sullenberger LE, Lee HJ, Lee JK, Grace KA| title=Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol (ARBITER) 2: a double-blind, placebo-controlled study of extended-release niacin on atherosclerosis progression in secondary prevention patients treated with statins. | journal=Circulation | year= 2004 | volume= 110 | issue= 23 | pages= 3512-7 | pmid=15537681 | doi=10.1161/01.CIR.0000148955.19792.8D | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15537681  }} </ref>
+| Circulation, 2004
+| Assess the long-term efficacy and safety of five lipid-influencing drugs
+| Double-blind randomized placebo-controlled study
+| 167 patients (mean age 67 years), h/o coronary heart disease, low HDL(<45 mg/dL)
+| 1 year
+| Once-daily extended-release niacin (1000 mg) added to background statin therapy
+| Increase in HDL-C by 21% and unchanged mean CIMT in the niacin group after 12 months
+| Decreases progression of carotid artery disease in patients with atherosclerosis and statin therapy
+|-
+|}
-===Side-effects===
-* Flushing
-* Pruritus
-* Nausea
-* Hepatitis (higher doses)
-===Contraindication===
-* Hypersensitivity
-* Hepatic disease
-===Supportive trial data===
 ==References==
 {{Reflist|2}}
-[[fr:Hypertriglycéridémie]]
+{{Lipopedia}}
-[[pt:Hipertrigliceridemia]]
+[[Category:Lipopedia]]
 [[Category:Cardiology]]
 [[Category:Dermatology]]

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Basic Science	Cholesterol • Triglyceride Lipoprotein metabolism and transport Lipoprotein: Chylomicron • Chylomicron remnant • HDL • IDL • LDL • Lipoprotein(a) • VLDL • Lipoprotein-X Apolipoprotein: APOA (1, 2, 4, 5) • APOB ( Apolipoprotein B-48, Apolipoprotein B-100) • APOC (1, 2, 3, 4) • APOD • APOE • APOH • APOJ • APOL • APOM • Apo(a) Lipoprotein receptor: LDL receptor • Soluble low density lipoprotein receptor-related protein (sLRP) • Apolipoprotein E Receptor 2 • Scavenger receptor • Scavenger receptor A • Scavenger receptor B • VLDL receptor Lipoprotein enzymes: Lipoprotein lipase • Lipoprotein-associated phospholipase A2 (Lp-PLA2) • Cholesterylester transfer protein ( Acetyl-CoA C-acyltransferase, Lecithin-cholesterol acyltransferase) • Microsomal triglyceride transfer protein • ABCA1 Genes: Low density lipoprotein receptor gene family • Microsomal triglyceride transfer protein • ABCA1
Lipoprotein Disorders	Lipoprotein disorders Primary lipoprotein disorders: Familial hyperchylomicronemia (Type I) • Familial hypercholesterolemia (Type IIA) • Familial combined hyperlipidemia (Type IIB) • Dysbetalipoproteinemia (Type III) • Primary hypertriglyceridemia (Type IV) • Mixed hyperlipoproteinemia (Type V) Secondary lipoprotein disorders
Abnormal Laboratory Lipid Profile	Low chylomicron • Low chylomicron remnant • Low HDL • Low IDL • Low LDL • Low lipoprotein(a) • Low VLDL High chylomicron • High chylomicron remnant • High HDL • High IDL • High LDL • High Lipoprotein(a) • High VLDL

Hypertriglyceridemia niacin: Difference between revisions

Latest revision as of 19:59, 23 November 2016

Overview

Supportive Trial Data

References

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