Benefits of niacin in patients with versus without the metabolic syndrome and healed myocardial infarction (from the Coronary Drug Project)

被引:106
作者
Canner, PL [1 ]
Furberg, CD
McGovern, ME
机构
[1] Maryland Med Res Inst, Baltimore, MD USA
[2] Wake Forest Univ, Winston Salem, NC 27109 USA
[3] Kos Div Med Affairs, Weston, FL USA
关键词
D O I
10.1016/j.amjcard.2005.08.070
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This post hoc analysis from the Coronary Drug Project (CDP) evaluated the effects of niacin monotherapy on clinical outcomes in patients with and without the metabolic syndrome (MS). The CDP was a randomized, placebo-controlled clinical trial of lipid-modifying agents in men with previous myocardial infarction (MI). Of the 5 drug regimens, only niacin significantly decreased definite recurrent nonfatal MI at 6 years and total mortality at a 15-year follow-up. Patients treated with niacin (n = 1,119) and placebo (n = 2,787) were grouped according to the presence or absence of the MS at baseline. The MS was defined on the basis of meeting >= 3 of 5 criteria from the current National Cholesterol Education Program guidelines in a small subgroup of patients with high-density lipoprotein cholesterol determinations at baseline and on the basis of >= 3 of 4 criteria in the total population, excluding the high-density lipoprotein cholesterol criterion. Niacin decreased the occurrence of 6-year MI and 15-year total mortality similarly among patients with or without the MS. For example, in the total population, 15-year total mortality rates were 60% and 64% (hazard ratio 0.86) in patients with the MS treated with niacin and placebo, respectively, and 50% and 57% (hazard ratio 0.86) in those without the MS (Z for interaction = 0.06, indicating homogeneity of the treatment effect across groups). In conclusion, these results support the use of niacin in postinfarction patients with and without the MS. (c) 2006 Elsevier Inc. All rights reserved.
引用
收藏
页码:477 / 479
页数:3
相关论文
共 8 条
[1]  
[Anonymous], 1975, JAMA-J AM MED ASSOC, V231, P360
[2]   Benefits of niacin by glycemic status in patients with healed myocardial infarction (from the coronary drug project) [J].
Canner, PL ;
Furberg, CD ;
Terrin, ML ;
McGovern, ME .
AMERICAN JOURNAL OF CARDIOLOGY, 2005, 95 (02) :254-257
[3]   15 YEAR MORTALITY IN CORONARY DRUG PROJECT PATIENTS - LONG-TERM BENEFIT WITH NIACIN [J].
CANNER, PL ;
BERGE, KG ;
WENGER, NK ;
STAMLER, J ;
FRIEDMAN, L ;
PRINEAS, RJ ;
FRIEDEWALD, W .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1986, 8 (06) :1245-1255
[4]  
COX DR, 1972, J R STAT SOC B, V34, P187
[5]  
FRIEDEWALD WT, 1972, CLIN CHEM, V18, P499
[6]   Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report [J].
Grundy, SM ;
Becker, D ;
Clark, LT ;
Cooper, RS ;
Denke, MA ;
Howard, WJ ;
Hunninghake, DB ;
Illingworth, R ;
Luepker, RV ;
McBride, P ;
McKenney, JM ;
Pasternak, RC ;
Stone, NJ ;
Van Horn, L ;
Brewer, HB ;
Cleeman, JI ;
Ernst, ND ;
Gordon, D ;
Levy, D ;
Rifkind, B ;
Rossouw, JE ;
Savage, P ;
Haffner, SM ;
Orloff, DG ;
Proschan, MA ;
Schwartz, JS ;
Sempos, CT ;
Shero, ST ;
Murray, EZ ;
Keller, SA ;
Jehle, AJ .
CIRCULATION, 2002, 106 (25) :3143-3421
[7]   Definition of metabolic syndrome - Report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition [J].
Grundy, SM ;
Brewer, HB ;
Cleeman, JI ;
Smith, SC ;
Lenfant, C .
CIRCULATION, 2004, 109 (03) :433-438
[8]  
The Coronary Drug Project Research Group, 1973, CIRCULATION, V47, P11