Matches in SemOpenAlex for { <https://semopenalex.org/work/W2103043503> ?p ?o ?g. }
- W2103043503 abstract "Background Nicotinic acid (niacin) is known to decrease LDL‐cholesterol, and triglycerides, and increase HDL‐cholesterol levels. The evidence of benefits with niacin monotherapy or add‐on to statin‐based therapy is controversial. Objectives To assess the effectiveness of niacin therapy versus placebo, administered as monotherapy or add‐on to statin‐based therapy in people with or at risk of cardiovascular disease (CVD) in terms of mortality, CVD events, and side effects. Search methods Two reviewers independently and in duplicate screened records and potentially eligible full texts identified through electronic searches of CENTRAL, MEDLINE, Embase, Web of Science, two trial registries, and reference lists of relevant articles (latest search in August 2016). Selection criteria We included all randomised controlled trials (RCTs) that either compared niacin monotherapy to placebo/usual care or niacin in combination with other component versus other component alone. We considered RCTs that administered niacin for at least six months, reported a clinical outcome, and included adults with or without established CVD. Data collection and analysis Two reviewers used pre‐piloted forms to independently and in duplicate extract trials characteristics, risk of bias items, and outcomes data. Disagreements were resolved by consensus or third party arbitration. We conducted random‐effects meta‐analyses, sensitivity analyses based on risk of bias and different assumptions for missing data, and used meta‐regression analyses to investigate potential relationships between treatment effects and duration of treatment, proportion of participants with established coronary heart disease and proportion of participants receiving background statin therapy. We used GRADE to assess the quality of evidence. Main results We included 23 RCTs that were published between 1968 and 2015 and included 39,195 participants in total. The mean age ranged from 33 to 71 years. The median duration of treatment was 11.5 months, and the median dose of niacin was 2 g/day. The proportion of participants with prior myocardial infarction ranged from 0% (4 trials) to 100% (2 trials, median proportion 48%); the proportion of participants taking statin ranged from 0% (4 trials) to 100% (12 trials, median proportion 100%). Using available cases, niacin did not reduce overall mortality (risk ratio (RR) 1.05, 95% confidence interval (CI) 0.97 to 1.12; participants = 35,543; studies = 12; I2 = 0%; high‐quality evidence), cardiovascular mortality (RR 1.02, 95% CI 0.93 to 1.12; participants = 32,966; studies = 5; I2 = 0%; moderate‐quality evidence), non‐cardiovascular mortality (RR 1.12, 95% CI 0.98 to 1.28; participants = 32,966; studies = 5; I2 = 0%; high‐quality evidence), the number of fatal or non‐fatal myocardial infarctions (RR 0.93, 95% CI 0.87 to 1.00; participants = 34,829; studies = 9; I2 = 0%; moderate‐quality evidence), nor the number of fatal or non‐fatal strokes (RR 0.95, 95% CI 0.74 to 1.22; participants = 33,661; studies = 7; I2 = 42%; low‐quality evidence). Participants randomised to niacin were more likely to discontinue treatment due to side effects than participants randomised to control group (RR 2.17, 95% CI 1.70 to 2.77; participants = 33,539; studies = 17; I2 = 77%; moderate‐quality evidence). The results were robust to sensitivity analyses using different assumptions for missing data. Authors' conclusions Moderate‐ to high‐quality evidence suggests that niacin does not reduce mortality, cardiovascular mortality, non‐cardiovascular mortality, the number of fatal or non‐fatal myocardial infarctions, nor the number of fatal or non‐fatal strokes but is associated with side effects. Benefits from niacin therapy in the prevention of cardiovascular disease events are unlikely." @default.
- W2103043503 created "2016-06-24" @default.
- W2103043503 creator A5019888759 @default.
- W2103043503 creator A5041641205 @default.
- W2103043503 creator A5043452234 @default.
- W2103043503 creator A5051590935 @default.
- W2103043503 creator A5066810053 @default.
- W2103043503 creator A5074510368 @default.
- W2103043503 creator A5075098080 @default.
- W2103043503 date "2017-06-14" @default.
- W2103043503 modified "2023-10-03" @default.
- W2103043503 title "Niacin for primary and secondary prevention of cardiovascular events" @default.
- W2103043503 cites W125680830 @default.
- W2103043503 cites W145425403 @default.
- W2103043503 cites W1486824465 @default.
- W2103043503 cites W1504402037 @default.
- W2103043503 cites W150670263 @default.
- W2103043503 cites W1566044237 @default.
- W2103043503 cites W1856460279 @default.
- W2103043503 cites W1859162852 @default.
- W2103043503 cites W1959291640 @default.
- W2103043503 cites W1965908094 @default.
- W2103043503 cites W1965952643 @default.
- W2103043503 cites W1966431818 @default.
- W2103043503 cites W1968660758 @default.
- W2103043503 cites W1972846585 @default.
- W2103043503 cites W1975931406 @default.
- W2103043503 cites W1977787417 @default.
- W2103043503 cites W1980243442 @default.
- W2103043503 cites W1980454378 @default.
- W2103043503 cites W1982224576 @default.
- W2103043503 cites W1982351423 @default.
- W2103043503 cites W1983999556 @default.
- W2103043503 cites W1986304796 @default.
- W2103043503 cites W1991065972 @default.
- W2103043503 cites W1992330736 @default.
- W2103043503 cites W1994954183 @default.
- W2103043503 cites W1996447072 @default.
- W2103043503 cites W1996592745 @default.
- W2103043503 cites W1997299383 @default.
- W2103043503 cites W1999405539 @default.
- W2103043503 cites W1999603233 @default.
- W2103043503 cites W2000958077 @default.
- W2103043503 cites W2003847068 @default.
- W2103043503 cites W2007239019 @default.
- W2103043503 cites W2009580736 @default.
- W2103043503 cites W2010173489 @default.
- W2103043503 cites W2011382665 @default.
- W2103043503 cites W2012074634 @default.
- W2103043503 cites W2014083842 @default.
- W2103043503 cites W2014894063 @default.
- W2103043503 cites W2015708524 @default.
- W2103043503 cites W2019071303 @default.
- W2103043503 cites W2023813030 @default.
- W2103043503 cites W2025468498 @default.
- W2103043503 cites W2026737636 @default.
- W2103043503 cites W2027750202 @default.
- W2103043503 cites W2028308533 @default.
- W2103043503 cites W2028737910 @default.
- W2103043503 cites W2029465901 @default.
- W2103043503 cites W2029833995 @default.
- W2103043503 cites W2035333536 @default.
- W2103043503 cites W2039172250 @default.
- W2103043503 cites W2039302239 @default.
- W2103043503 cites W2039517796 @default.
- W2103043503 cites W2042650201 @default.
- W2103043503 cites W2044465607 @default.
- W2103043503 cites W2044507358 @default.
- W2103043503 cites W2045452486 @default.
- W2103043503 cites W2046991199 @default.
- W2103043503 cites W2047693255 @default.
- W2103043503 cites W2048070048 @default.
- W2103043503 cites W2048766067 @default.
- W2103043503 cites W2050906039 @default.
- W2103043503 cites W2051556928 @default.
- W2103043503 cites W2052188710 @default.
- W2103043503 cites W2052568385 @default.
- W2103043503 cites W2053599662 @default.
- W2103043503 cites W2055318521 @default.
- W2103043503 cites W2055790796 @default.
- W2103043503 cites W2058867908 @default.
- W2103043503 cites W2059934146 @default.
- W2103043503 cites W2061161053 @default.
- W2103043503 cites W2063149202 @default.
- W2103043503 cites W2063728789 @default.
- W2103043503 cites W2063921997 @default.
- W2103043503 cites W2064968463 @default.
- W2103043503 cites W2068944125 @default.
- W2103043503 cites W2070345301 @default.
- W2103043503 cites W2070855777 @default.
- W2103043503 cites W2073638666 @default.
- W2103043503 cites W2074571762 @default.
- W2103043503 cites W2077421021 @default.
- W2103043503 cites W2077771812 @default.
- W2103043503 cites W2078489774 @default.
- W2103043503 cites W2079408175 @default.
- W2103043503 cites W2080243329 @default.
- W2103043503 cites W2082031296 @default.
- W2103043503 cites W2084571470 @default.
- W2103043503 cites W2084675507 @default.