AIM-HIGH Trial: Niacin + Statins in Hyperlipidemia

aim high trial niacin

2011 AIM-HIGH TRIAL Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy Placebo controlled, randomized clinical trial Σ Objective: To assess if extended-release niacin added to simvastatin to raise low levels of high-density lipoprotein (HDL) cholesterol is superior to simvastatin alone in reducing residual cardiovascular risk. 3,414 patients Inclusion criteria: patients with established CV disease with HDL cholesterol (<40 mg/dl for men; <50 mg/dl for women), elevated triglyceride levels 150 to 400 mg/dl, and LDL cholesterol<180 mg/dl 16.2 placebo + statin (n=1,696) VS niacin + statin (n=1,718) PRIMARY OUTCOME Death from CAD, nonfatal MI, stroke, or hospitalization for ACS or revascularization % HR 1.02; 95% CI, 0.87 to 1.21; P=0.80 SECONDARY OUTCOME 16.4 Death from CAD, nonfatal MI, 9.3 stroke, or hospitalization for ACS% HR 1.08; 95% CI, 0.87 to 1.34; P=0.49 10 2.2 Death from CV causes % P=0.47 2.6 Conclusion: Among patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of less than 70 mg per deciliter (1.81 mmol per liter), there was no incremental clinical benefit from the addition of niacin to statin therapy during a 36-month follow-up period, despite significant improvements in HDL cholesterol and triglyceride levels. AIM-HIGH Investigators, et al. NEJM, 2011; 365:2255-2267