THE EFFECTS OF EXTENDED RELEASE NIACIN IN COMBINATION WITH OMEGA 3 FATTY ACID SUPPLEMENTS IN THE TREATMENT OF ELEVATED LIPOPROTEIN(A)

Objective. To assess the effectiveness of niacin/fish oil combination therapy in reducing Lipoprotein (a) [Lp(a)] levels after twelve weeks of therapy. Background. Lipoprotein (a) accumulates in atherosclerotic lesions and promotes smoothmuscle cell growth and is both atherogenic and thrombogenic. A clinical trials of combination therapy for the reduction of Lp(a) has not been previously reported. Methods. The study was an observational study following subjects with an elevated Lp(a) (> 70 nmol/L) to assess impact of 12 weeks of combination Omega 3FA, niacin, and theMediterranean diet on Lp(a). Results. Twenty three patients were enrolled with 7 patients lost to follow up and 2 patients stopped due to adverse events. The average Lp(a) reduction in the remaining 14 subjects after 12 weeks of combination therapy was 23% +/- 17%[P =.003] with a significant association of the reduction of Lp(a) with increasing baseline levels of Lp(a) [R-2 = 0.633, P =.001]. Conclusions. There was a significant reduction in Lp(a) levels with combination therapy. A more pronounced effect was noted in patients with higher baseline levels of Lp(a).