This significant effect was derived by the use of fibrates ( RR 0.80 , 95 % CI 0.73–0.87 , P < 0.001 , I2 = 22 % ) and meta-regression analysis showed that this benefit was consistent with an absolute reduction in low-density lipoprotein cholesterol .
Meta-regression analyses failed to demonstrate a significant association of pharmacologically increased high-density lipoprotein cholesterol with key endpoints .
Conclusion The use of high-density lipoprotein cholesterol modifying treatments had no significant effect on cardiovascular mortality , stroke or all-cause mortality .
The beneficial effect on myocardial infa rct ion was lost when drugs were used with statin therapy
Background The effects of increasing high-density lipoprotein cholesterol on cardiovascular outcomes remain uncertain .
Design We conducted a meta- analysis to investigate the effects of high-density lipoprotein cholesterol modifiers ( niacin , fibrates and cholesteryl ester transfer protein inhibitors ) on cardiovascular outcomes .
Lipid-altering efficacy and safety of ezetimibe/simvastatin coadministered with extended-release niacin in patients with type IIa or type IIb hyperlipidemia.
OBJECTIVES This study evaluated the safety and lipid-altering efficacy of ezetimibe/simvastatin ( E/S ) coadministered with extended-release niacin ( N ) in patients with type IIa or IIb hyperlipidemia . BACKGROUND Current guidelines recommend consideration of combination drug therapy to achieve optimal low-density lipoprotein cholesterol ( LDL-C ) lowering and broader lipid-altering effects when treating hypercholesterolemic patients at high risk for atherosclerotic cardiovascular events . METHODS In this 24-week multicenter , r and omized , double-blind study , 1,220 type IIa or IIb hyperlipidemic patients were r and omized to treatment with E/S ( 10/20 mg/day ) + N ( titrated to 2 g/day ) , or N ( titrated to 2 g/day ) , or E/S ( 10/20 mg/day ) . Changes from baseline in LDL-C ( primary ) and other secondary variables were assessed in the completers and modified intent-to-treat population s. RESULTS Coadministered E/S with N result ed in significantly greater reductions in LDL-C , non-high-density lipoprotein cholesterol , triglycerides , apolipoprotein B , and lipid/lipoprotein ratios , compared with either agent alone ( p < 0.001 ) . The combination increased levels of apolipoprotein A-I and high-density lipoprotein cholesterol significantly more than E/S ( p < 0.001 ) , and reduced high-sensitivity C-reactive protein levels significantly more than N ( p = 0.005 ) . A significantly greater percentage of patients discontinued the study in the N ( 25.0 % ) and N + E/S ( 23.3 % ) groups , compared with E/S ( 9.6 % , p < 0.001 ) because of clinical adverse experiences ( primarily flushing ) . Incidences of other clinical and laboratory adverse experiences ( liver- , muscle- , and gastrointestinal-related ) were similar for all groups . CONCLUSIONS Combination treatment with E/S plus N showed superior lipid-altering efficacy compared with N or E/S in type IIa or IIb hyperlipidemia patients and was generally well tolerated aside from N-associated flushing . This combination offers an effective , broad , lipid-altering therapy with improvements in lipid effects beyond LDL-C in these patients . ( To Evaluate Ezetimibe/Simvastatin and Niacin [ Extended Release Tablet ] in Patients With High Cholesterol
This significant effect was derived by the use of fibrates ( RR 0.80 , 95 % CI 0.73–0.87 , P < 0.001 , I2 = 22 % ) and meta-regression analysis showed that this benefit was consistent with an absolute reduction in low-density lipoprotein cholesterol .
Meta-regression analyses failed to demonstrate a significant association of pharmacologically increased high-density lipoprotein cholesterol with key endpoints .
Conclusion The use of high-density lipoprotein cholesterol modifying treatments had no significant effect on cardiovascular mortality , stroke or all-cause mortality .
The beneficial effect on myocardial infa rct ion was lost when drugs were used with statin therapy
Background The effects of increasing high-density lipoprotein cholesterol on cardiovascular outcomes remain uncertain .
Design We conducted a meta- analysis to investigate the effects of high-density lipoprotein cholesterol modifiers ( niacin , fibrates and cholesteryl ester transfer protein inhibitors ) on cardiovascular outcomes .