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Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglyceride and Impact on Global Health Outcomes

Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglyceride and Impact on Global Health Outcomes  (AIM HIGH)


Coronary heart disease (CHD) is the leading cause of death and disability in the Western world. Approximately 12.6 million people in the US have a history of heart attack, chest pain, or both. Vascular disease that causes symptoms in the US is also high. Approximately 7 – 12 million people in the US are impacted. Both groups of people have a very high long-term risk of a repeat heart attack and/or stroke. The cost of treating these conditions is huge. In the US the costs are about $112 billion dollars for CHD and about $49 billion for stroke.


In the past 20 years numerous clinical studies have demonstrated that lipid-lowering therapy reduces the risk of cardiovascular death, heart attacks and strokes.  The National Cholesterol Education Program of the NIH has recommended that patients with cardiovascular disease or diabetes, like yourself, should lower your LDL cholesterol (the bad cholesterol) to less than 100 mg/dl.  We also recognized that many patients with vascular disease also have low levels of HDL (the good cholesterol) and elevated triglycerides.  We have medications, such as niacin, which can increase HDL and/or lower triglycerides. Preliminary research using statin combination therapy (statin plus niacin) showed a major decrease in repeat CHD events as well as nearly stopping atherosclerosis from getting worse. However, taking a statin with niacin is not currently recommended by the National Cholesterol Education Program because this combination has not been studied for preventing CHD in a group of similar people where half take the statin only and the other half take the statin plus niacin.


The purpose of this study is to compare the effectiveness and safety of statin therapy alone, simvastatin (Zocor) and statin combination therapy (simvastatin plus niacin extended release) in reducing repeat CHD events over time.  Statin therapy blocks the production of cholesterol.  Niacin is a B-complex vitamin. Simvastatin alone will lower the rate of repeat events including death from coronary heart disease, heart attacks, strokes, and hospitalization for acute coronary syndrome.

Last Updated: 08-19-2016
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