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

Ferrell et al.¹ recently reported associations between serum levels of the terminal niacin metabolites N1-methyl-2-pyridone-5-carboxamide (2PY) and N1-methyl-4-pyridone-3-carboxamide (4PY) with an increased 3-year incident risk of major adverse cardiovascular events. The association of 4PY with cardiovascular risk was linked to increased endothelial VCAM-1 expression and increased leukocyte adherence to the vascular endothelium as a potential causal mechanism. The study suggests that niacin supplementation may be harmful by increasing cardiovascular morbidity and mortality. Strikingly, the exact mechanism identified as a potential adverse outcome by Ferrell et al.¹ has been noted to be suppressed with niacin supplementation², arguing for a more complex interpretation of the findings. Here, we would like to briefly put the study of Ferrell et al.¹ into the perspective of decades of clinical trial experience and pharmacovigilance with nicotinic acid (niacin) and nicotinamide, the two forms of vitamin B₃.

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

费雷尔等人。 ¹最近报道了末端烟酸代谢物N 1-甲基-2-吡啶酮-5-甲酰胺 (2PY) 和N 1-甲基-4-吡啶酮-3-甲酰胺 (4PY) 的血清水平与 3 年发病率增加之间的关联主要不良心血管事件的风险。 4PY 与心血管风险的关联与内​​皮 VCAM-1 表达增加和白细胞对血管内皮粘附增加有关，这是一种潜在的因果机制。研究表明，补充烟酸可能会增加心血管发病率和死亡率，从而有害。引人注目的是，Ferrell 等人确定了潜在不良后果的确切机制。 ¹已被注意到会因补充烟酸而受到抑制² ，因此需要对研究结果进行更复杂的解释。在这里，我们想简单介绍一下Ferrell等人的研究。 ¹从数十年的临床试验经验和烟酸（烟酸）和烟酰胺（维生素 B ₃的两种形式）药物警戒的角度来看。