Effects of Nicotinic Acid Plus Simvastatin Versus Simvastatin Alone on Carotid and Femoral Intima-Media Thickness in Patients With Peripheral Artery Disease (NASCIT)
Information source: Medical University of Vienna
ClinicalTrials.gov processed this data on August 23, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Dyslipidemia; Atherosclerosis
Intervention: simvastatin (Drug); Nicotinic Acid (Drug)
Phase: Phase 4
Status: Recruiting
Sponsored by: Medical University of Vienna Official(s) and/or principal investigator(s): Renate Koppensteiner, Prof. Dr., Principal Investigator, Affiliation: Division of Angiology, Department of Internal Medicine II, Medical University Vienna
Summary
Dyslipidaemia is characterized by low plasma levels of high-density lipoprotein cholesterol
(HDL-c), elevated triglycerides and an increase in low density lipoprotein (LDL-c)
particles, and has been unequivocally established as a most important cardiovascular risk
factor. While statins are effective in reducing plasma levels of LDL-c, these drugs have
only modest effects on raising HDL-c (typically by less than 10%), even with aggressive
statin therapy. However, increasing evidence suggests that low HDL-c might be at least as
relevant as high LDL-c in promoting the development and progression of atherosclerosis. The
beneficial effect of raising HDL-c on clinical outcome has already been demonstrated by
several studies.
Nicotinic acid is the most potent agent available for raising plasma levels of HDL-c by up
to 29% at clinically recommended doses, and substantially lowers triglycerides and LDL-c.
Furthermore, nicotinic acid is also the most potent lipid lowering agent available that
reduces Lp(a), an independent marker of cardiovascular risk. In a recent study patients with
coronary artery disease had a 21% increase in HDL-c and a 13% decrease in triglycerides, and
these beneficial effects on lipid status may have contributed to a stabilization or
regression of carotid intima-media-thickness (IMT).The impact in patients with advanced
atherosclerosis like peripheral artery disease (PAD) in unknown.
The investigators hypothesized that nicotinic acid in addition to statin therapy may inhibit
progression of peripheral arterial atherosclerosis. Therefore, the aim of the present
randomized controlled trial is to investigate the effects of nicotinic acid (daily dose
starting with 500 mg, up to 2000mg) in addition to simvastatin (40 mg daily) versus
simvastatin (40mg daily) monotherapy in patients with low serum HDL-C levels and PAD with
respect to changes of carotid and femoral IMT, changes of patients´ lipid status and
occurrence of major adverse cardiovascular events (MACE).
Clinical Details
Official title: Effects of Nicotinic Acid Plus Simvastatin Versus Simvastatin Alone on Carotid and Femoral Intima-Media Thickness in Patients With Peripheral Artery Disease (NASCIT)-A Randomized Controlled Trial
Study design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Primary outcome: change of carotid and femoral IMT from baseline to 6 and 12 months follow up and occurrence of major adverse cardiovascular events (MACE)
Secondary outcome: changes of grey scale median (GSM) score from baseline to follow-up, and changes of serum levels of total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides and lipoprotein (a).
Eligibility
Minimum age: 18 Years.
Maximum age: N/A.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- PAD defined as an ABI ≤0. 9 or >1. 3 in patients with low serum HDL cholesterol levels
(<45mg/dL in men, <55 mg/dL in women)
Exclusion Criteria:
- Elevated liver enzymes (above 2 times the normal level)
- Skeletal muscle myopathy or elevated serum CK levels
- Allergy or hypersensibility to either statins or nicotinic acid
- Women of childbearing potential
Locations and Contacts
Medical University Vienna, Vienna 1090, Austria; Recruiting Renate Koppensteiner, Prof. Dr., Phone: 00431404004671, Email: renate.koppensteiner@meduniwien.ac.at Martin Schillinger, Prof. Dr., Sub-Investigator Jasmin Amighi, Dr., Sub-Investigator Schila Sabeti, Dr., Sub-Investigator
Additional Information
Starting date: June 2008
Last updated: July 20, 2011
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