In this third up date of the Cochrane review , there were no differences in effects of homocysteine-lowering interventions in the form of supplements of vitamins B6 , B9 or B12 given alone or in combination comparing with placebo on myocardial infa rct ion , death from any cause or adverse events .
BACKGROUND Cardiovascular disease , which includes coronary artery disease , stroke and peripheral vascular disease , is a leading cause of death worldwide .
Homocysteine is an amino acid with biological functions in methionine metabolism .
A postulated risk factor for cardiovascular disease is an elevated circulating total homocysteine level .
The impact of homocysteine-lowering interventions , given to patients in the form of vitamins B6 , B9 or B12 supplements , on cardiovascular events has been investigated .
This is an up date of a review previously published in 2009 , 2013 , and 2015 .
OBJECTIVES To determine whether homocysteine-lowering interventions , provided to patients with and without pre-existing cardiovascular disease are effective in preventing cardiovascular events , as well as reducing all-cause mortality , and to evaluate their safety .
B vitamin treatments modify the risk of myocardial infarction associated with a MTHFD1 polymorphism in patients with stable angina pectoris.
BACKGROUND Methylenetetrahydrofolate dehydrogenase ( MTHFD1 ) catalyzes three sequential reactions that metabolize derivatives of tetrahydrofolate ( THF ) in folate-dependent one-carbon metabolism . Impaired MTHFD1 flux has been linked to disturbed lipid metabolism and oxidative stress . However , limited information is available on its relation to the development of atherothrombotic cardiovascular disease . METHODS AND RESULTS We explored the association between a MTHFD1 polymorphism ( rs1076991 C > T ) and acute myocardial infa rct ion ( AMI ) , and potential effect modifications by folic acid/B12 and /or vitamin B6 treatment in suspected stable angina pectoris patients ( n = 2381 ) participating in the r and omized Western Norway B Vitamin Intervention Trial ( WENBIT ) . During the median follow-up of 4.9 years 204 participants ( 8.6 % ) suffered an AMI . After adjusting for established CVD risk factors , the MTHFD1 polymorphism was significantly associated with AMI ( HR : 1.49 ; 95 % CI , 1.23 - 1.81 ) . A similar association was observed among patients allocated to treatment with vitamin B6 alone ( HR : 1.53 ; 95 % CI , 1.01 - 2.31 ) , and an even stronger relationship was seen in patients treated with both vitamin B6 and folic acid/B12 ( HR : 2.35 ; 95 % CI , 1.55 - 3.57 ) . However , no risk association between the MTHFD1 polymorphism and AMI was seen in patients treated with placebo ( HR : 1.29 ; 95 % CI , 0.86 - 1.93 ) or folic acid/B12 ( 1.17 ; 95 % CI , 0.83 - 1.65 ) . CONCLUSION A common and functional MTHFD1 polymorphism is associated with increased risk of AMI , although the risk seems to be dependent on specific B vitamin treatment . Further studies are warranted to eluci date the possible mechanisms , also in order to explore potential effect modifications by nutritional factors
In this third up date of the Cochrane review , there were no differences in effects of homocysteine-lowering interventions in the form of supplements of vitamins B6 , B9 or B12 given alone or in combination comparing with placebo on myocardial infa rct ion , death from any cause or adverse events .
BACKGROUND Cardiovascular disease , which includes coronary artery disease , stroke and peripheral vascular disease , is a leading cause of death worldwide .
Homocysteine is an amino acid with biological functions in methionine metabolism .
A postulated risk factor for cardiovascular disease is an elevated circulating total homocysteine level .
The impact of homocysteine-lowering interventions , given to patients in the form of vitamins B6 , B9 or B12 supplements , on cardiovascular events has been investigated .
This is an up date of a review previously published in 2009 , 2013 , and 2015 .
OBJECTIVES To determine whether homocysteine-lowering interventions , provided to patients with and without pre-existing cardiovascular disease are effective in preventing cardiovascular events , as well as reducing all-cause mortality , and to evaluate their safety .