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American Heart Association Late Breaking Clinical Trial Report: In Patients on Statins, Raising Good Cholesterol with Niacin, but not Reducing Bad Cholesterol with Ezetimibe, Decreases Plaque Build-Up
Date:11/15/2009

Study highlights:

In patients with or at high-risk for coronary artery disease and LDL (bad cholesterol) treated with statins to < 100mg/dL but low HDL (good cholesterol), adding medication to raise HDL was compared with lowering LDL further.

Patients were randomized to the addition of niacin (primarily to raise HDL), or ezetimibe (to further lower LDL cholesterol). Plaque buildup in the lining of the neck arteries was significantly reduced only in the niacin group.

DUE TO AN EMBARGO BREAK, THE EMBARGO ON THIS STUDY IS RELEASED

ORLANDO, Fla., Nov. 15 /PRNewswire-USNewswire/ -- In combination with statins, adding a medication that raises high-density lipoprotein (HDL) cholesterol was more effective in reversing artery wall plaque buildup and in reducing heart disease risk than adding a drug that lowers low-density lipoprotein (LDL) cholesterol, researchers reported today at the American Heart Association Scientific Sessions 2009.

In the study titled The Effect of Extended-release Niacin or Ezetimibe Added to Chronic Statin Therapy On Carotid Intima Media Thickness (ARBITER 6-HALTS), researchers found:

  • Adding the cholesterol drug niacin to a statin improved HDL ("good") cholesterol levels and significantly reduced arterial plaque buildup within 8 months, with further improvement seen at the end of the study (14 months).
  • A second approach, adding ezetimibe to a statin, lowered LDL ("bad") cholesterol to a greater extent, but did not raise HDL. With it, there was no overall effect on arterial build up in the neck arteries.
  • With ezetimibe, greater reductions in LDL cholesterol paradoxically were associated with more arterial buildup, a result opposite to that expected.
  • The incidence of major cardiovascular events such as fatal and non-fatal heart attack was higher in the ezetimibe gro
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SOURCE American Heart Association
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