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Niacin for primary and secondary prevention of cardiovascular events

Overview of attention for article published in Cochrane database of systematic reviews, June 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (95th percentile)
  • High Attention Score compared to outputs of the same age and source (86th percentile)

Mentioned by

news
1 news outlet
twitter
67 tweeters
facebook
7 Facebook pages
wikipedia
2 Wikipedia pages

Citations

dimensions_citation
23 Dimensions

Readers on

mendeley
110 Mendeley
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Title
Niacin for primary and secondary prevention of cardiovascular events
Published in
Cochrane database of systematic reviews, June 2017
DOI 10.1002/14651858.cd009744.pub2
Pubmed ID
Authors

Stefan Schandelmaier, Matthias Briel, Ramon Saccilotto, Kelechi K Olu, Armon Arpagaus, Lars G Hemkens, Alain J Nordmann

Abstract

Nicotinic acid (niacin) is known to decrease LDL-cholesterol, and triglycerides, and increase HDL-cholesterol levels. The evidence of benefits with niacin monotherapy or add-on to statin-based therapy is controversial. To assess the effectiveness of niacin therapy versus placebo, administered as monotherapy or add-on to statin-based therapy in people with or at risk of cardiovascular disease (CVD) in terms of mortality, CVD events, and side effects. Two reviewers independently and in duplicate screened records and potentially eligible full texts identified through electronic searches of CENTRAL, MEDLINE, Embase, Web of Science, two trial registries, and reference lists of relevant articles (latest search in August 2016). We included all randomised controlled trials (RCTs) that either compared niacin monotherapy to placebo/usual care or niacin in combination with other component versus other component alone. We considered RCTs that administered niacin for at least six months, reported a clinical outcome, and included adults with or without established CVD. Two reviewers used pre-piloted forms to independently and in duplicate extract trials characteristics, risk of bias items, and outcomes data. Disagreements were resolved by consensus or third party arbitration. We conducted random-effects meta-analyses, sensitivity analyses based on risk of bias and different assumptions for missing data, and used meta-regression analyses to investigate potential relationships between treatment effects and duration of treatment, proportion of participants with established coronary heart disease and proportion of participants receiving background statin therapy. We used GRADE to assess the quality of evidence. We included 23 RCTs that were published between 1968 and 2015 and included 39,195 participants in total. The mean age ranged from 33 to 71 years. The median duration of treatment was 11.5 months, and the median dose of niacin was 2 g/day. The proportion of participants with prior myocardial infarction ranged from 0% (4 trials) to 100% (2 trials, median proportion 48%); the proportion of participants taking statin ranged from 0% (4 trials) to 100% (12 trials, median proportion 100%).Using available cases, niacin did not reduce overall mortality (risk ratio (RR) 1.05, 95% confidence interval (CI) 0.97 to 1.12; participants = 35,543; studies = 12; I(2) = 0%; high-quality evidence), cardiovascular mortality (RR 1.02, 95% CI 0.93 to 1.12; participants = 32,966; studies = 5; I(2) = 0%; moderate-quality evidence), non-cardiovascular mortality (RR 1.12, 95% CI 0.98 to 1.28; participants = 32,966; studies = 5; I(2) = 0%; high-quality evidence), the number of fatal or non-fatal myocardial infarctions (RR 0.93, 95% CI 0.87 to 1.00; participants = 34,829; studies = 9; I(2) = 0%; moderate-quality evidence), nor the number of fatal or non-fatal strokes (RR 0.95, 95% CI 0.74 to 1.22; participants = 33,661; studies = 7; I(2) = 42%; low-quality evidence). Participants randomised to niacin were more likely to discontinue treatment due to side effects than participants randomised to control group (RR 2.17, 95% CI 1.70 to 2.77; participants = 33,539; studies = 17; I(2) = 77%; moderate-quality evidence). The results were robust to sensitivity analyses using different assumptions for missing data. Moderate- to high-quality evidence suggests that niacin does not reduce mortality, cardiovascular mortality, non-cardiovascular mortality, the number of fatal or non-fatal myocardial infarctions, nor the number of fatal or non-fatal strokes but is associated with side effects. Benefits from niacin therapy in the prevention of cardiovascular disease events are unlikely.

Twitter Demographics

The data shown below were collected from the profiles of 67 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 110 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Australia 1 <1%
United States 1 <1%
Netherlands 1 <1%
Unknown 107 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 25 23%
Student > Bachelor 21 19%
Unspecified 20 18%
Student > Ph. D. Student 8 7%
Researcher 7 6%
Other 29 26%
Readers by discipline Count As %
Medicine and Dentistry 43 39%
Unspecified 27 25%
Nursing and Health Professions 14 13%
Biochemistry, Genetics and Molecular Biology 6 5%
Pharmacology, Toxicology and Pharmaceutical Science 4 4%
Other 16 15%

Attention Score in Context

This research output has an Altmetric Attention Score of 51. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 July 2019.
All research outputs
#327,440
of 13,249,240 outputs
Outputs from Cochrane database of systematic reviews
#919
of 10,536 outputs
Outputs of similar age
#13,226
of 266,839 outputs
Outputs of similar age from Cochrane database of systematic reviews
#33
of 242 outputs
Altmetric has tracked 13,249,240 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 10,536 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.7. This one has done particularly well, scoring higher than 91% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 266,839 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 95% of its contemporaries.
We're also able to compare this research output to 242 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.