The effects of niacin on hs-crp levels in patients with non st elevated acutecoronary syndrome

Niacin, a potent agent for raising high density lipoprotein cholesterol levels is able to prevent rupture by stabilizing plaque and reducing the rate of atherosclerosis progression. But its effects on surrogate markers of atherosclerosis and inflammatory markers in non ST elevated acute coronary syndrome are less clear. In this study, we studied the effects of niacin on hs-CRP and cholesterol levels in non ST elevated acute coronary syndrome patients. In this prospective, randomised open study, 48 non ST elevated acute coronary syndrome patients; receiving optimal medical therapy and accepted to participate to the trial; were randomised to niacin group (25 patients, 16 male, mean age 63±12 years) or control group (23 patients, 14 male, mean age 64±13 years) according to their demographic findings. Niacin slow released form 500 mg/day was added to medical treatment regime for one month in niacin group and only optimal medical therapy was continued in control group. Blood samples for hs-CRP were obtained from patients at admittance to coronary care unit, in third day and in first month of the treatment. Blood samples for cholesterol levels were obtained before and 30 Baseline demographic, clinical and laboratory characteristics were similar in both niacin and control groups. Baseline and 3 day after the treatment. rd day hs-CRP levels were similar in both groups but hs-CRP level in niacin group at 1st month was significantly lower than control group (2,9±2,2 in niacin group; 5,9±5,8 in control group; p= 0,034). In the follow up HDL cholesterol level was increased in niacin group but this difference was not significant. In the control group, HDL cholesterol levels were not changed at 1st month. Two deaths were seen in control group, there was no death in niacin group. Drug related side effects were seen in 7 patients in niacin group but no patients discontinued the niacin. v Our findings demonstrated that, the addition of low dose niacin therapy to the optimal therapy in non ST elevated acute coronary syndrome patients causes a significant decrease in an important inflammatory parameter hs-CRP