No link between nicotinamide exposure and MACE

Adults who are exposed to nicotinamide do not appear to be at increased risk of major cardiovascular events (MACE), according to a large retrospective cohort study.

For the study, researchers used electronic health record data of two patient cohorts, the Vanderbilt University Medical Center (VUMC) and Million Veteran Program (MVP). MACE risk was compared between patients exposed to nicotinamide and those unexposed.

The total study population comprised 13,108 patients (mean age 66.8 years, 91.0 percent male). In the VUMC cohort, 1,228 patients were exposed to nicotinamide, while 253 were unexposed. The corresponding numbers in the MVP cohort were 4,063 and 7,564 patients. The total number of exposed patients was 5,291.

Patient characteristics such as age, sex, race, and ethnicity were similar between the exposed and unexposed groups. Compared with nonexposure, nicotinamide exposure did not lead to a substantial increase in the cumulative incidence of MACE in either the VUMC or MVP cohort.

Adjusted cause-specific models stratified by history of prior MACE showed that nicotinamide exposure was not associated with the risk of MACE in the VUMC cohort (no prior MACE: hazard ratio [HR], 2.02, 95 percent confidence interval [CI], 0.81–5.05; prior MACE: HR, 0.46, 95 percent CI, 0.22–0.95) and the MVP cohort (no prior MACE: HR, 1.07, 95 percent CI, 0.75–1.17; prior MACE: HR, 1.04, 95 percent CI, 0.53–2.06).