Pleiotropic effects of niacin: Current possibilities for its clinical use

Abstract Niacin was the first hypolipidemic drug to significantly reduce both major cardiovascular events and mortality in patients with cardiovascular disease. Niacin favorably influences all lipoprotein classes, including lipoprotein[a],and belongs to the most potent hypolipidemic drugs for increasing HDL-C. Moreover, niacin causes favorable changes to the qualitative composition of lipoprotein HDL. In addition to its pronounced hypolipidemic action, niacin exerts many other, non-hypolipidemic effects (e.g., antioxidative, anti-inflammatory, antithrombotic), which favorably influence the development and progression of atherosclerosis. These effects are dependent on activation of the specific receptor HCA2. Recent results published by the two large clinical studies, AIM-HIGH and HPS2-THRIVE, have led to the impugnation of niacin’s role in future clinical practice. However, due to several methodological flaws in the AIM-HIGH and HPS2-THRIVE studies, the pleiotropic effects of niacin now deserve thorough evaluation. This review summarizes the present and possible future use of niacin in clinical practice in light of its newly recognized pleiotropic effects.

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331 ASSOCIATION OF FIB4 SCORE WITH MAJOR CARDIOVASCULAR EVENTS (MACE) IN REAL-WORLD POPULATIONS DIAGNOSED WITH NASH OR NAFLD IN US CLINICAL PRACTICE

Gastroenterology ◽

10.1016/s0016-5085(20)33833-6 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-1269-S-1270

Author(s):

Michelle Lai ◽

Jeremy Broestl ◽

Andrew Frick ◽

Richard Haubrich ◽

Bruce Koch ◽

...

Keyword(s):

Clinical Practice ◽

Real World ◽

Cardiovascular Events ◽

Major Cardiovascular Events

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Association of FIB-4 score with major cardiovascular events (MACE) in real-world populations diagnosed with NASH or NAFLD in US clinical practice

Journal of Hepatology ◽

10.1016/s0168-8278(20)30826-6 ◽

2020 ◽

Vol 73 ◽

pp. S159-S160

Author(s):

Michelle Lai ◽

Jeremy Broestl ◽

Andrew Frick ◽

Richard Haubrich ◽

Bruce Koch ◽

...

Keyword(s):

Clinical Practice ◽

Real World ◽

Cardiovascular Events ◽

Major Cardiovascular Events

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Squalene monooxygenase – a target for hypercholesterolemic therapy

Biological Chemistry ◽

10.1515/bc.2011.195 ◽

2011 ◽

Vol 392 (12) ◽

pp. 1053-1075 ◽

Cited By ~ 25

Author(s):

Agnieszka Belter ◽

Miroslawa Skupinska ◽

Malgorzata Giel-Pietraszuk ◽

Tomasz Grabarkiewicz ◽

Leszek Rychlewski ◽

...

Keyword(s):

Clinical Practice ◽

Clinical Evidence ◽

Cholesterol Biosynthesis ◽

Cardiovascular Prevention ◽

Cost Effective ◽

Clinical Use ◽

Cellular Cholesterol ◽

Squalene Monooxygenase ◽

Hypolipidemic Drugs ◽

Hypocholesterolemic Agents

Abstract Squalene monooxygenase catalyzes the epoxidation of C-C double bond of squalene to yield 2,3-oxidosqualene, the key step of sterol biosynthesis pathways in eukaryotes. Sterols are essential compounds of these organisms and squalene epoxidation is an important regulatory point in their synthesis. Squalene monooxygenase downregulation in vertebrates and fungi decreases synthesis of cholesterol and ergosterol, respectively, which makes squalene monooxygenase a potent and attractive target of hypercholesterolemia and antifungal therapies. Currently some fungal squalene monooxygenase inhibitors (terbinafine, naftifine, butenafine) are in clinical use, whereas mammalian enzymes’ inhibitors are still under investigation. Research on new squalene monooxygenase inhibitors is important due to the prevalence of hypercholesterolemia and the lack of both sufficient and safe remedies. In this paper we (i) review data on activity and the structure of squalene monooxygenase, (ii) present its inhibitors, (iii) compare current strategies of lowering cholesterol level in blood with some of the most promising strategies, (iv) underline advantages of squalene monooxygenase as a target for hypercholesterolemia therapy, and (v) discuss safety concerns about hypercholesterolemia therapy based on inhibition of cellular cholesterol biosynthesis and potential usage of squalene monooxygenase inhibitors in clinical practice. After many years of use of statins there is some clinical evidence for their adverse effects and only partial effectiveness. Currently they are drugs of choice but are used with many restrictions, especially in case of children, elderly patients and women of childbearing potential. Certainly, for the next few years, statins will continue to be a suitable tool for cost-effective cardiovascular prevention; however research on new hypolipidemic drugs is highly desirable. We suggest that squalene monooxygenase inhibitors could become the hypocholesterolemic agents of the future.

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Erectile dysfunction and cardiovascular disease: Focus on

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2014.48 ◽

2015 ◽

Vol 82 (2) ◽

Author(s):

Roberto F.E. Pedretti ◽

Michele Gabriele ◽

Sergio Masnaghetti ◽

Pompilio Faggiano

Keyword(s):

Cardiovascular Disease ◽

Erectile Dysfunction ◽

Clinical Practice ◽

Cardiovascular Events ◽

Clinical Problem ◽

Major Cardiovascular Events ◽

Predictive Role ◽

Common Risk Factors ◽

Common Clinical Problem ◽

Disease Focus

Erectile dysfunction (ED) is a common clinical problem and its prevalence increases in frequency with age. ED is a risk marker for major cardiovascular events independently of other more common risk factors in men with and without known cardiovascular disease. On the basis of the “artery-size hypothesis” patients with cardiovascular disease often report ED before disease detection, in average 3 years. Thus, by an early identification of ED, the cardiologist is given a unique opportunity to better assess the cardiovascular risk of each patient. Although there is a general impression that ED has an important predictive role, its diagnosis in clinical practice is widely suboptimal owing to misconceptions from the side of the patient and a suboptimal management of the personal relationship from the side of the physician. This paper explores the critical connection between ED and cardiovascular disease and evaluates how this association may influence clinical practice.

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Psoriasis and the Risk of Major Cardiovascular Events: Cohort Study Using the Clinical Practice Research Datalink

Journal of Investigative Dermatology ◽

10.1038/jid.2015.87 ◽

2015 ◽

Vol 135 (9) ◽

pp. 2189-2197 ◽

Cited By ~ 80

Author(s):

Rosa Parisi ◽

Martin K. Rutter ◽

Mark Lunt ◽

Helen S. Young ◽

Deborah P.M. Symmons ◽

...

Keyword(s):

Cohort Study ◽

Clinical Practice ◽

Cardiovascular Events ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Major Cardiovascular Events

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Cardiac MRI to Manage Atrial Fibrillation

Arrhythmia & Electrophysiology Review ◽

10.15420/aer.2020.21 ◽

2020 ◽

Vol 9 (4) ◽

pp. 189-194

Author(s):

Yan Zhao ◽

Lilas Dagher ◽

Chao Huang ◽

Peter Miller ◽

Nassir F Marrouche

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

Clinical Practice ◽

Cardiac Mri ◽

Cardiovascular Events ◽

Clinical Implications ◽

Major Cardiovascular Events ◽

Severe Effect ◽

Underlying Substrate

AF is the most common arrhythmia in clinical practice. In addition to the severe effect on quality of life, patients with AF are at higher risk of stroke and mortality. Recent studies have suggested that atrial and ventricular substrate play a major role in the development and maintenance of AF. Cardiac MRI has emerged as a viable tool for interrogating the underlying substrate in AF patients. Its advantage includes localisation and quantification of structural remodelling. Cardiac MRI of the atrial substrate is not only a tool for management and treatment of arrhythmia, but also to individualise the prevention of stroke and major cardiovascular events. This article provides an overview of atrial imaging using cardiac MRI and its clinical implications in the AF population.

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Hybrid Telecoaching for Corporate Speech Training and Potential Applications to Clinical Practice

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig3-2018-0012 ◽

2019 ◽

Vol 4 (2) ◽

pp. 322-324

Author(s):

Thomas F. Burke

Keyword(s):

Clinical Practice ◽

Engineering Teams ◽

Corporate Strategies ◽

Corporate Speech ◽

Phone Calls ◽

Future Clinical Practice ◽

Fortune 100 ◽

Potential Applications ◽

Language Pathology ◽

Development Engineering

Purpose The purpose of this article was to describe a model for “hybrid speech telecoaching” developed for a Fortune 100 organization and offer a “thought starter” on how clinicians might think of applying these corporate strategies within future clinical practice. Conclusion The author contends in this article that corporate telecommunications and best practices gleaned from software development engineering teams can lend credibility to e-mail, messaging apps, phone calls, or other emerging technology as viable means of hybrid telepractice delivery models and offer ideas about the future of more scalable speech-language pathology services.

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