There was a greater risk for acute coronary syndrome (odds ratio 1.85, 95% confidence interval 1.16‐2.77, P=0.02) and revascularization events (odds ratio 1.64, 95% confidence interval 1.2‐2.22, P=0.002) in major allele carriers at the CYP26A1 locus in the placebo group not seen in the niacin group. Here, CYP26A1 is linked to acute coronary syndrome.