<International Circulation>:  If you are someone with a low LDL level and HDL is not considered optimal， is niacin something that could be considered to treat this?

  《国际循环》：倘若患者LDL水平低而HDL水平却并不理想，那么是否可以考虑烟酸这类药物来进行治疗？

    Prof. Boden:   We don’t have data yet to support that.  If you are talking about primary prevention then there is zero data on primary prevention for whether that would be advantageous.  I make decisions based on individualized risk profiles.  If there is a patient with a positive family history， premature coronary disease， very low levels of HDL， and high triglycerides， a case could be made in that particular patient that there may be some benefit to taking niacin， although you would have to be fair to the patient and say that the clinical trial data at present is inconclusive.  I do agree that we need to wait for the larger trials.  There were fairly significant designs between the VA HIT and AIM studies.  If one were starting off with a population of 50 and go to 60 you are on the flat part of the event curve.  It may also not provide us the answer we seek.  If this was a study like VA HIT that targeted a low HDL group， in that regard it is a unique population.  

    Boden教授: 我们的研究数据尚不能支持你的观点。如果你是指初级预防的话，那就更没有任何数据证实烟酸是否有利于治疗。我是基于个体化风险特征得出这些结论。如果患者有阳性家族史、早发性冠心病、HDL水平极低和高甘油三酯，那么针对这种特定患者服用烟酸可能会有疗效。但你将不得不向患者坦白，目前的临床试验数据尚未明确这种疗效。我认为，需要开展更大型的试验来阐明这一问题。如果一个试验的研究人群在50至60人，那就达到这一事件曲线的平台，可能无法为我们提供所寻求的答案；倘若是像VA HIT那种规模的针对HDL低水平的患者，那么这些患者就是一个独特的人群。

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