High Niacin Levels Associated with Cardiovascular Events

Core Concepts

Excess niacin metabolites linked to cardiovascular events.

Abstract

TOPLINE:

Excess niacin breakdown products 2PY and 4PY linked to major cardiovascular events.
METHODOLOGY:

Metabolomics analysis on stable cardiac patients revealed associations with myocardial infarction and stroke.
Genetic analyses tested the association with sVCAM-1 levels.
TAKEAWAY:

Niacin metabolism linked to major adverse cardiovascular events.
Plasma levels of 2PY and 4PY associated with increased MACE risk.
IN PRACTICE:

Niacin supplementation may require a nuanced approach to avoid adverse effects.
SOURCE:

Study led by Stanley Hazen, MD, PhD, published in Nature Medicine.
LIMITATIONS:

Limited serial measures of 2PY and 4PY in validation cohorts.
High-risk populations studied may limit generalizability.

Stats

"Plasma levels of the terminal metabolites of excess niacin, 2PY and 4PY, were associated with increased 3-year MACE risk in two validation cohorts."
"Adjusted hazard ratios for 2PY of 1.64 and 2.02, respectively, and for 4PY, 1.89 and 1.99."
"Total niacin consumption in the US averaged 48 mg/d from 2017 to 2020."

Quotes

"Niacin metabolism was associated with incident major adverse cardiovascular events (MACE)."
"Treatment with physiological levels of 4PY, but not 2PY, induced expression of VCAM-1 and leukocyte adherence to vascular endothelium."

Key Insights Distilled From

High Niacin Levels Linked to Major CV Events

by Marilynn Lar... at www.medscape.com 02-21-2024

https://www.medscape.com/viewarticle/high-niacin-levels-linked-major-cv-events-2024a10003gk

Deeper Inquiries

How can individuals optimize their niacin intake to reduce cardiovascular risk?

To optimize niacin intake and reduce cardiovascular risk, individuals should consider a more nuanced and titrated approach to supplementation. Excess niacin intake can lead to the production of harmful metabolites like 2PY and 4PY, which have been strongly associated with major adverse cardiovascular events. Therefore, it is crucial to avoid excessive niacin consumption, especially through supplements like nicotinamideriboside and nicotinamide mononucleotide, which are commonly used for their antiaging benefits. Maintaining niacin levels within recommended daily allowances and avoiding high doses that can lead to the generation of detrimental metabolites is essential for cardiovascular health.

What are the implications of these findings on current niacin supplementation practices?

The findings of this study have significant implications for current niacin supplementation practices. The research suggests that the traditional approach to niacin supplementation may need to be reevaluated to prevent the production of harmful metabolites like 2PY and 4PY, which are linked to increased cardiovascular risk. The study highlights the importance of a more tailored and controlled approach to niacin intake to achieve the intended health benefits without promoting the generation of detrimental metabolites. This calls for a shift towards a more personalized and nuanced strategy when it comes to niacin supplementation to mitigate the risk of major adverse cardiovascular events.

How might the study's focus on metabolites impact future cardiovascular research?

The study's focus on metabolites, specifically 2PY and 4PY, can have a significant impact on future cardiovascular research. By identifying these metabolites as strong indicators of myocardial infarction, stroke, and other adverse cardiac events, the study sheds light on the intricate relationship between niacin metabolism and cardiovascular health. Future research in the field of cardiovascular health may now need to consider the impact of metabolites generated from niacin supplementation on cardiovascular outcomes. This study opens up new avenues for exploring the role of metabolites in cardiovascular disease and may lead to the development of more targeted interventions and treatments based on metabolite profiles. The focus on metabolites in this study underscores the importance of understanding the metabolic pathways involved in cardiovascular health and disease.