Back to Browse Journals » Vascular Health and Risk Management » Volume 3 » Issue 1

Relationship between glycemic status and progression of carotid intima-media thickness during treatment with combined statin and extended-release niacin in ARBITER 2

Authors Allen J Taylor, Daming Zhu, Lance E Sullenberger, Hyun J Lee, Jeannie K Lee, Karen A Grace

Published 15 March 2007 Volume 2007:3(1) Pages 159—164

Allen J Taylor, Daming Zhu, Lance E Sullenberger, Hyun J Lee, Jeannie K Lee, Karen A Grace

Cardiology Service, Walter Reed Army Medical Center, Washington, DC, USA

Background: We previously reported in a placebo-controlled study that extended-release niacin slowed the progression of carotid atherosclerosis when added to statin monotherapy. This analysis examines the relationship between glycemic status and the effects of niacin on common carotid intima-media thickness (CIMT) and HDL cholesterol.

Methods: Post-hoc, subgroup analysis of ARBITER 2, a randomized, placebo-controlled trial of once-daily extended-release niacin (1000 mg) added to background statin therapy in 167 patients (mean age 67 years) with known coronary heart disease. The primary analysis was a comparison of the primary endpoint, the change in CIMT, between participants with either normal glycemic status, diabetes mellitus (DM) or the metabolic syndrome (MS).

Results: Baseline cardiovascular risk variables were significantly worse in those with abnormal glycemic status, particularly among subjects with MS. Niacin increased HDL-C to a similar degree (~20%) across normals, DM and MS. Placebo-treated patients had the greatest CIMT progression, regardless of glycemic status. The lowest progression rate was observed in niacin treated patients with normal glycemic status. Among all niacin treated subjects, there was a significant linear relationship between change in CIMT and change in HDL-C (r = –0.16; p = 0.05), which was of similar magnitude in subgroups with normal glycemic status (r = –0.23; p = 0.08) and DM (r = –0.22; p = 0.17). In those with MS, there was no relationship between changes in HDL and CIMT, (r = 0.11; p = 0.44), whereas blood glucose was positive correlated to change in CIMT (r = 0.30; p = 0.04). In multivariable linear models controlling for MS characteristics and blood glucose changes, only the change in HDL independently predicted change in CIMT.

Conclusions: During niacin treatment, increases in HDL-C are related to changes in CIMT in the setting of both normal glycemic status and diabetes mellitus.

Keywords: atherosclerosis, risk factors, lipids, diabetes mellitus

Download Article [PDF] 

Readers of this article also read:

Update on the everolimus-eluting coronary stent system: results and implications from the SPIRIT clinical trial program

R Michael Kirchner, J Dawn Abbott

Vascular Health and Risk Management 2009, 5:1089-1097

Published Date: 16 December 2009

Targeting mulitple dyslipidemias with fixed combinations – focus on extended release niacin and simvastatin

Anbu Pandian, Anjali Arora, Laurence S Sperling, Bobby V Khan

Vascular Health and Risk Management 2008, 4:1001-1009

Published Date: 10 October 2008

Correlation of microalbumin and sialic acid with anthropometric variables in type 2 diabetic patients with and without nephropathy

B Shivananda Nayak, Heidi Duncan, Sunita Lalloo, Kevin Maraj, Vani Matmungal, et al

Vascular Health and Risk Management 2008, 4:243-247

Published Date: 8 February 2008

Candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) and resource utilization and costs in Italy

Giorgio L Colombo, Mauro Caruggi, Chiara Ottolini, Aldo P Maggioni

Vascular Health and Risk Management 2008, 4:223-234

Published Date: 8 February 2008

Diagnosis and surgical approach of popliteal artery entrapment syndrome: a retrospective study

Stavros Gourgiotis, John Aggelakas, Nikolaos Salemis, Charalabos Elias, Charalabos Georgiou

Vascular Health and Risk Management 2008, 4:83-88

Published Date: 8 February 2008

Managing hypertension in diabetic patients – focus on trandolapril/verapamil combination

Sanjib Kumar Sharma, Piero Ruggenenti, Giuseppe Remuzzi

Vascular Health and Risk Management 2007, 3:453-465

Published Date: 15 September 2007

Vascular wall proteoglycan synthesis and structure as a target for the prevention of atherosclerosis

Peter J Little, Mandy L. Ballinger, Narin Osman

Vascular Health and Risk Management 2007, 3:117-124

Published Date: 15 March 2007

Foot ulcers in the diabetic patient, prevention and treatment

Stephanie C Wu, Vickie R Driver, James S Wrobel, David G Armstrong

Vascular Health and Risk Management 2007, 3:65-76

Published Date: 15 March 2007

Overweight, physical activity and high blood pressure in children: a review of the literature

Brian Torrance, K Ashlee McGuire, Richard Lewanczuk, Jonathan McGavock

Vascular Health and Risk Management 2007, 3:139-149

Published Date: 15 March 2007

Blood pressure normalization in a large population of hypertensive patients treated with perindopril/indapamide combination: results of the OPTIMAX trial

Jean-Jacques Mourad, Viet Nguyen, Marilucy Lopez-Sublet, Bernard Waeber

Vascular Health and Risk Management 2007, 3:173-180

Published Date: 15 March 2007