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 .
Effect of homocysteine-lowering B vitamin treatment on angiographic progression of coronary artery disease: a Western Norway B Vitamin Intervention Trial (WENBIT) substudy.
Total plasma homocysteine ( tHcy ) is an independent risk factor for coronary artery disease , and tHcy is lowered by B vitamins . To assess the effect of homocysteine-lowering B-vitamin treatment on angiographic progression of coronary artery disease , this sub study of the Western Norway B Vitamin Intervention Trial ( WENBIT ) included patients who had undergone percutaneous coronary intervention . The patients were r and omized to daily oral treatment with folic acid , vitamin B(12 ) , and vitamin B(6 ) or placebo in a 2 x 2 factorial design . The coronary angiograms obtained at baseline and follow-up were evaluated . The primary angiographic end points were the changes in minimum lumen diameter and diameter stenosis .  A total of 348 subjects ( 288 men ) with a mean + /- SD age of 60 + /- 10.2 years were followed up for a median of 10.5 months ( twenty-fifth , seventy-fifth percentile 9.2 , 11.8 ) . The baseline median plasma tHcy level was 10.0 mumol/L ( twenty-fifth , seventy-fifth percentile 8.1 , 11.0 ) , and treatment with folic acid/vitamin B(12 ) lowered the tHcy levels by 22 % . At follow-up , we found 309 lesions with a significant decrease from baseline in the minimum lumen diameter of a mean of -0.16 + /- 0.4 mm and an increase in the diameter stenosis of 4.4 + /- 0.7 % . Treatment with folic acid/vitamin B(12 ) or vitamin B(6 ) was not associated with a change in diameter stenosis or minimum lumen diameter . In a post hoc analysis , folic acid/vitamin B(12 ) treatment was significantly associated with rapid progression ( odds ratio 1.84 , 95 % confidence interval 1.07 to 3.18 ) . In conclusion , vitamin B treatment showed no beneficial effect on the angiographic progression of coronary artery disease , and the post hoc analyses suggested that folic acid/vitamin B(12 ) treatment might promote more rapid progression
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 .