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Niacin and Lipoprotein(a): Facts, Uncertainties, and Clinical Considerations

2008; Elsevier BV; Volume: 101; Issue: 8 Linguagem: Inglês

10.1016/j.amjcard.2008.02.031

1879-1913

Angelo M. Scanu, Ravi Bamba,

Plant biochemistry and biosynthesis

Over the years, niacin has gained recognition as an atheroprotective agent, in part because of its capacity to lower the plasma levels of cholesterol, triglycerides, and very-low- and low-density lipoproteins and to substantially raise high-density lipoprotein. In high doses, niacin has also been reported to lower the plasma level of lipoprotein(a) (Lp[a]). However, the published research on the subject suffers from a lack of uniformity regarding patient selection, drug dose, length of administration, and methods for plasma Lp(a) quantification. In this report, the authors examine the most relevant niacin-related Lp(a) studies and hypothetical mechanisms of drug action, also considering the emerging notion of Lp(a) as a potential proinflammatory entity.