Review article

https://doi.org/10.1515/acph-2016-0043

Pleiotropic effects of niacin: Current possibilities for its clinical use

MIROSLAV ZEMAN orcid.org/0000-0001-5338-603X ; 4th Department of Medicine, 1st Faculty of Medicine, Charles University in Prague Prague, Czech Republic
MAREK VECKA orcid.org/0000-0002-3269-1817 ; 4th Department of Medicine, 1st Faculty of Medicine, Charles University in Prague Prague, Czech Republic
FRANTIŠEK PERLÍK ; Institute of Pharmacology, 1st Faculty of Medicine, Charles University in Prague Prague, Czech Republic
BARBORA STAŇKOVÁ ; 4th Department of Medicine, 1st Faculty of Medicine, Charles University in Prague Prague, Czech Republic
ROBERT HROMÁDKA ; Research and Development Center, C2P s.r.o., Chlumec/n Cidlinou, Czech Republic
EVA TVRZICKÁ ; 4th Department of Medicine, 1st Faculty of Medicine, Charles University in Prague Prague, Czech Republic
JAKUB ŠIRC ; Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic Prague, Czech Republic
JAKUB HRIB ; Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic Prague, Czech Republic
ALEŠ ŽÁK ; 4th Department of Medicine, 1st Faculty of Medicine, Charles University in Prague Prague, Czech Republic

Abstract

Niacin was the first hypolipidemic drug to significantly reduce both major cardiovascular events and mortality in patients with cardiovascular disease. Niacin favorably influences all lipoprotein classes, including lipoproteina,and belongs to the most potent hypolipidemic drugs for increasing HDL-C. Moreover, niacin causes favorable changes to the qualitative composition of lipoprotein HDL. In addition to its pronounced hypolipidemic action, niacin exerts many other, non-hypolipidemic effects (e.g., antioxidative, anti-inflammatory, antithrombotic), which favorably influence the development and progression of atherosclerosis. These effects are dependent on activation of the specific receptor HCA2. Recent results published by the two large clinical studies, AIM-HIGH and HPS2-THRIVE, have led to the impugnation of niacin’s role in future clinical practice. However, due to several methodological flaws in the AIM-HIGH and HPS2-THRIVE studies, the pleiotropic effects of niacin now deserve thorough evaluation. This review summarizes the present and possible future use of niacin in clinical practice in light of its newly recognized pleiotropic effects.

Keywords

niacin; pleiotropic effects; HCA2 receptor; dyslipidemia; cardiovascular mortality/morbidity

Hrčak ID:

161190

URI

https://hrcak.srce.hr/161190

Publication date:

31.12.2016.

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