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 .
A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians.
OBJECTIVE To assess prospect ively the risk of coronary heart disease associated with elevated plasma levels of homocyst(e)ine . DESIGN Nested case-control study using prospect ively collected blood sample s. SETTING Participants in the Physicians ' Health Study . PARTICIPANTS A total of 14,916 male physicians , aged 40 to 84 years , with no prior myocardial infa rct ion ( MI ) or stroke provided plasma sample s at baseline and were followed up for 5 years . Sample s from 271 men who subsequently developed MI were analyzed for homocyst(e)ine levels together with paired controls , matched by age and smoking . MAIN OUTCOME MEASURE Acute MI or death due to coronary disease . RESULTS Levels of homocyst(e)ine were higher in cases than in controls ( 11.1 + /- 4.0 [ SD ] vs 10.5 + /- 2.8 nmol/mL ; P = .03 ) . The difference was attributable to an excess of high values among men who later had MIs . The relative risk for the highest 5 % vs the bottom 90 % of homocyst(e)ine levels was 3.1 ( 95 % confidence interval , 1.4 to 6.9 ; P = .005 ) . After additional adjustment for diabetes , hypertension , aspirin assignment , Quetelet 's Index , and total/high-density lipoprotein cholesterol , this relative risk was 3.4 ( 95 % confidence interval , 1.3 to 8.8 ) ( P = .01 ) . Thirteen controls and 31 cases ( 11 % ) had values above the 95th percentile of the controls . CONCLUSIONS Moderately high levels of plasma homocyst(e)ine are associated with subsequent risk of MI independent of other coronary risk factors . Because high levels can often be easily treated with vitamin supplements , homocyst(e)ine may be an independent , modifiable risk factor
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 .