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In This Issue of Archives of Internal Medicine
April 12, 2004

In This Issue of Archives of Internal Medicine

Arch Intern Med. 2004;164(7):696. doi:10.1001/archinte.164.7.696

The results of this population-based community study reveal marked decreases in length of stay for patients hospitalized with acute myocardial infarction over the last decade. Mean length of stay has decreased significantly from approximately 12 days in 1986-1988 to 6 days in 1997-1999. During this period, there was a 10-fold increase in the proportion of patients discharged home in less than 6 days. Even after adjusting for study year, age, comorbidities, myocardial infarction complications, and other potential prognostic confounders, no association between decreased length of stay and increased postdischarge mortality was observed.

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Appropriate management of dyslipidemia can significantly reduce cardiovascular morbidity and mortality. Niacin is unique in that it improves all lipoprotein abnormalities. It significantly reduces low-density lipoprotein cholesterol, triglycerides and lipoprotein(a) levels, while increasing high-density lipoprotein cholesterol level, making it ideal for a variety of dyslipidemias. Niacin may be used alone or in combination to improve lipid profile and reduce clinical events; however, tolerability issues have limited its wider use. Niacin is available in 3 formulations (immediate release, extended release, and long acting), and adverse effects are directly related to the specific formulation. This article reviews the use of niacin in a variety of dyslipidemias, the available niacin formulations, and provides guidance for improving patient tolerance and adherence.