Effect of extended-release niacin on serum lipids and on endothelial function in adults with sickle cell anemia and low high-density lipoprotein cholesterol levels

Heather M. Scoffone, Megan Krajewski, Suzana Zorca, Candice Bereal-Williams, Patricia Littel, Catherine Seamon, Laurel Mendelsohn, Eleni Footman, Nadine Abi-Jaoudeh, Vandana Sachdev, Roberto Machado, Michael Cuttica, Robert Shamburek, Richard O. Cannon, Alan Remaley, Caterina P. Minniti, Gregory J. Kato

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Through bound apolipoprotein A-I (apoA-I), high-density lipoprotein cholesterol (HDL-C) activates endothelial nitric oxide synthase, inducing vasodilation. Because patients with sickle cell disease (SCD) have low apoA-I and endothelial dysfunction, we conducted a randomized, double-blinded, placebo-controlled trial to test whether extended-release niacin (niacin-ER) increases apoA-I-containing HDL-C and improves vascular function in SCD. Twenty-seven patients with SCD with levels of HDL-C <39 mg/dl or apoA-I <99 mg/dl were randomized to 12 weeks of niacin-ER, increased in 500-mg increments to a maximum of 1,500 mg/day, or placebo. The primary outcome was the absolute change in HDL-C level after 12 weeks, with endothelial function assessed before and at the end of treatment. Niacin-ER-treated patients trended to greater increase in HDL-C level compared with placebo treatment at 12 weeks (5.1 ± 7.7 vs 0.9 ± 3.8 mg/dl, 1-tailed p = 0.07), associated with significantly greater improvements in the ratios of low-density lipoprotein to HDL-C levels (1.24 vs 1.95, p = 0.003) and apolipoprotein B to apoA-I levels (0.46 vs 0.58, p = 0.03) compared with placebo-treated patients. No improvements were detected in 3 independent vascular physiology assays of endothelial function. Thus, the relatively small changes in HDL-C levels achieved by the dose of niacin-ER used in our study are not associated with improved vascular function in patients with SCD with initially low levels of apoA-I or HDL-C.

Original languageEnglish (US)
Pages (from-to)1499-1504
Number of pages6
JournalAmerican Journal of Cardiology
Volume112
Issue number9
DOIs
StatePublished - Nov 1 2013
Externally publishedYes

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Niacin
Sickle Cell Anemia
Apolipoprotein A-I
LDL Cholesterol
HDL Cholesterol
Lipids
Serum
Placebos
Blood Vessels
Nitric Oxide Synthase Type III
Apolipoproteins B
LDL Lipoproteins
Vasodilation
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of extended-release niacin on serum lipids and on endothelial function in adults with sickle cell anemia and low high-density lipoprotein cholesterol levels. / Scoffone, Heather M.; Krajewski, Megan; Zorca, Suzana; Bereal-Williams, Candice; Littel, Patricia; Seamon, Catherine; Mendelsohn, Laurel; Footman, Eleni; Abi-Jaoudeh, Nadine; Sachdev, Vandana; Machado, Roberto; Cuttica, Michael; Shamburek, Robert; Cannon, Richard O.; Remaley, Alan; Minniti, Caterina P.; Kato, Gregory J.

In: American Journal of Cardiology, Vol. 112, No. 9, 01.11.2013, p. 1499-1504.

Research output: Contribution to journalArticle

Scoffone, HM, Krajewski, M, Zorca, S, Bereal-Williams, C, Littel, P, Seamon, C, Mendelsohn, L, Footman, E, Abi-Jaoudeh, N, Sachdev, V, Machado, R, Cuttica, M, Shamburek, R, Cannon, RO, Remaley, A, Minniti, CP & Kato, GJ 2013, 'Effect of extended-release niacin on serum lipids and on endothelial function in adults with sickle cell anemia and low high-density lipoprotein cholesterol levels', American Journal of Cardiology, vol. 112, no. 9, pp. 1499-1504. https://doi.org/10.1016/j.amjcard.2013.06.035
Scoffone, Heather M. ; Krajewski, Megan ; Zorca, Suzana ; Bereal-Williams, Candice ; Littel, Patricia ; Seamon, Catherine ; Mendelsohn, Laurel ; Footman, Eleni ; Abi-Jaoudeh, Nadine ; Sachdev, Vandana ; Machado, Roberto ; Cuttica, Michael ; Shamburek, Robert ; Cannon, Richard O. ; Remaley, Alan ; Minniti, Caterina P. ; Kato, Gregory J. / Effect of extended-release niacin on serum lipids and on endothelial function in adults with sickle cell anemia and low high-density lipoprotein cholesterol levels. In: American Journal of Cardiology. 2013 ; Vol. 112, No. 9. pp. 1499-1504.
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abstract = "Through bound apolipoprotein A-I (apoA-I), high-density lipoprotein cholesterol (HDL-C) activates endothelial nitric oxide synthase, inducing vasodilation. Because patients with sickle cell disease (SCD) have low apoA-I and endothelial dysfunction, we conducted a randomized, double-blinded, placebo-controlled trial to test whether extended-release niacin (niacin-ER) increases apoA-I-containing HDL-C and improves vascular function in SCD. Twenty-seven patients with SCD with levels of HDL-C <39 mg/dl or apoA-I <99 mg/dl were randomized to 12 weeks of niacin-ER, increased in 500-mg increments to a maximum of 1,500 mg/day, or placebo. The primary outcome was the absolute change in HDL-C level after 12 weeks, with endothelial function assessed before and at the end of treatment. Niacin-ER-treated patients trended to greater increase in HDL-C level compared with placebo treatment at 12 weeks (5.1 ± 7.7 vs 0.9 ± 3.8 mg/dl, 1-tailed p = 0.07), associated with significantly greater improvements in the ratios of low-density lipoprotein to HDL-C levels (1.24 vs 1.95, p = 0.003) and apolipoprotein B to apoA-I levels (0.46 vs 0.58, p = 0.03) compared with placebo-treated patients. No improvements were detected in 3 independent vascular physiology assays of endothelial function. Thus, the relatively small changes in HDL-C levels achieved by the dose of niacin-ER used in our study are not associated with improved vascular function in patients with SCD with initially low levels of apoA-I or HDL-C.",
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T1 - Effect of extended-release niacin on serum lipids and on endothelial function in adults with sickle cell anemia and low high-density lipoprotein cholesterol levels

AU - Scoffone, Heather M.

AU - Krajewski, Megan

AU - Zorca, Suzana

AU - Bereal-Williams, Candice

AU - Littel, Patricia

AU - Seamon, Catherine

AU - Mendelsohn, Laurel

AU - Footman, Eleni

AU - Abi-Jaoudeh, Nadine

AU - Sachdev, Vandana

AU - Machado, Roberto

AU - Cuttica, Michael

AU - Shamburek, Robert

AU - Cannon, Richard O.

AU - Remaley, Alan

AU - Minniti, Caterina P.

AU - Kato, Gregory J.

PY - 2013/11/1

Y1 - 2013/11/1

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