arising from M. Ferrell et al. Nature Medicine https://doi.org/10.1038/s41591-023-02793-8 (2024)

Ferrell et al.¹ report a surprisingly strong association between terminal metabolites of niacin and major adverse cardiovascular events (MACE), amounting to roughly a doubling of MACE risk in the 4th quartile of circulating levels of the 4PY (N¹-methyl-4-pyridone-3-carboxamide) metabolite. The results presented by Ferrell et al.¹ are impressive and deserve further attention. Here we would like to suggest alternative interpretations for these results; in particular, we discuss how two aspects of food intake—first, consumption of foods with high niacin content and, second, a historical shift from mealtime to bedtime administration of pharmacological niacin doses—could help explain cardiovascular effects ascribed to niacin.

arising from M. Ferrell et al. Nature Medicine https://doi.org/10.1038/s41591-023-02793-8 (2024)

费雷尔等人。 ¹报道烟酸终末代谢物与主要不良心血管事件 (MACE) 之间存在令人惊讶的强烈关联，相当于 4PY 循环水平的第四个四分位数 ( N ¹ -甲基-4-吡啶酮-3-) 的 MACE 风险大约增加一倍甲酰胺）代谢物。 Ferrell 等人提出的结果。 ¹令人印象深刻，值得进一步关注。在这里，我们想对这些结果提出替代解释；特别是，我们讨论了食物摄入的两个方面——第一，食用烟酸含量高的食物，第二，从进餐时到睡前服用药理烟酸剂量的历史转变——如何有助于解释烟酸对心血管的影响。