Supplementation with Niacin or ω-3 Fatty Acids Is Ineffective for Secondary Prevention

For patients with coronary disease, many clinicians add niacin to statin therapy (especially for patients with low HDL cholesterol) and recommend dietary supplementation with ω-3 fatty acids. Unfortunately, three trials failed to show benefit for either of these interventions.

In the AIM-HIGH study, 3414 patients with established cardiovascular disease were randomized to receive simvastatin (titrated to an LDL cholesterol goal of <80 mg/dL) plus either extended-release niacin or placebo. Enrolled men had HDL cholesterol levels <40 mg/dL, and women's levels were <50 mg/dL; triglyceride levels were between 150 and 400 mg/dL. Compared with placebo, niacin therapy induced significant changes in LDL cholesterol, HDL cholesterol, and triglyceride …