AIM-HIGH Trial stopped early

[bradtPA]

The trial studying simvastatin versus simvastatin combined with extended release niacin was stopped eighteen months early with no improvement in the endpoints, and a slight increase in strokes in the high dose arm of the trial.

 

http://www.theheart.org/article/1231453.do

 

Looks like there could be some flaws in the trial design, such as adding ezetimebe to keep LDL at the target range of 40 to 80, and tracking strokes for up to four years after the drug was discontinued as a negative outcome.

[xxbowiexx]

That's interesting that niacin did not show any improvement in the high trig/ low HDL pts. I see the statin/niacin combo being used quite often in that patient population when i did my FP rotation.

[springpearl]

What's the best treatment for pt whose on statin with normal HDL LDL but high triglycerides (>250, <500)? I mean other than low fat diet, exercises, fish oil. Thanks.

[sbellin]

Of note this study was for secondary prevention events in those with known disease. It did not address primary prevention

[bradtPA]

What's the best treatment for pt whose on statin with normal HDL LDL but high triglycerides (>250, <500)? I mean other than low fat diet, exercises, fish oil. Thanks.

 

Thats a good question. The ACCORD trial failed to show benefit in combining statins with fenofibrates in diabetics. The FIELD trial failed to show mortality benefits with the same combination, but did reduce non- fatal MIs. Lovaza is an excellent tool to reduce triglycerides, but I know of no study involving lovaza that shows secondary MI prevention.

 

If it was my patient with only elevated trigs at the levels you mention, I would recommend a low carb diet first and foremost, then fish oil 4 caps daily.

[d2305]

Short Abbott stock today.

[d2305]

Disregard it's up. So much for that theory.