Changing Up This Blog (Also Niacin, LDL, and Atherosclerosis)

This blog doesn’t get much activity these days, so I’ve decided to use it to post about studies I find interesting. These will be brief and not very in depth. First up, a clinical trial published in the NEJM in 2009:

Taylor AJ, Villines TC, Stanek EJ, Devine PJ, Griffen L, Miller M, Weissman NJ, Turco M. Extended-release niacin or ezetimibe and carotid intima-media thickness. N Engl J Med. 2009 Nov 26;361(22):2113-22.

This study looked at atherosclerosis progression in 200 people (mostly men) with low LDL (below 100; all were taking a statin) and low HDL (below 50-55). These subjects either had heart disease or were at a high risk of it. Subjects were given one of two drugs: niacin (technically vitamin B3 btw) or ezetimibe. The former is known to lower triglycerides, raise HDL, and slightly lower LDL while the latter is known only to lower LDL. Sure enough, this is pretty much what these compounds did:

Picture 8

So what was the effect on atherosclerosis?

image

Ezetimibe produced no significant effect on artery thickness (which could be good—for all we know without this drug atherosclerosis would worsened rather than stayed constant). Meanwhile, the niacin user saw a net regression, meaning they saw an apparent reversal of atherosclerosis. Cool stuff. If this study is to be believed it provides evidence that lowering LDL isn’t all their is to reversing plaque build up int he arteries. Lower triglycerides and higher HDL may be important as well.

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