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In a different setting, i.e., patients presenting with stable chest pain (of whom 10% had known previous CAD and obstructive CAD was identified in 26%), the CT substudy of SCOT-HEART showed that high-attenuation (i.e., lipid-rich) plaques were independently associated with spontaneous myocardial infarctions throughout five years of follow-up, irrespective of coronary artery stenosis65

Conclusion: direct IV NAD+ has a real biological effect , although the mechanism is more complex than simple replenishment of the NAD+ pool (via metabolites)

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"Mechanism of action and epitopes of Clostridium difficile toxin B-neutralizing antibody bezlotoxumab revealed by X-ray crystallography"