Attainment of combined optimal lipid values with the use of niacin: has AIM-HIGH closed the book on this debate?

The AIM-HIGH study results have provided new information for the clinical question regarding the potential benefit of the attainment of optimal lipid values to reduce residual cardiovascular risk in patients on optimal statin therapy. At first glance, it would seem that the early termination of this study owing to the perceived clinical futility of niacin therapy has effectively closed the debate on this topic. However, it is imperative that the clinician probes deeper into the study design and results before coming to this conclusion. This report will review the AIM-HIGH results and the impact on the clinical practice of adding niacin to optimized statin therapy in order to reduce residual cardiovascular risk.