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 Long-Term Homocysteine Reduction with B Vitamins on Arterial Wall Inflammation Assessed by Fluorodeoxyglucose Positron Emission Tomography: A Randomised Double-Blind, Placebo-Controlled Trial
Background : Homocysteine may promote atherosclerosis by exacerbating inflammatory processes within the arterial wall . B-vitamin supplements reduce total plasma homocysteine concentrations ( tHcy ) , but it is not known whether the treatment also reduces arterial wall inflammation . We used 18F-fluorodeoxygluose positron emission tomography ( 18F-FDG PET ) to investigate whether long-term homocysteine-lowering treatment alters arterial wall inflammation in patients with a history of ischemic stroke . Methods : 30 stroke patients were r and omly assigned to B-vitamin therapy ( folic acid 2 mg , vitamin B6 25 mg and vitamin B12 0.5 mg ) or placebo in a double-blind clinical trial . After a mean treatment period of 4.0 ± 0.7 years , all subjects had tHcy , carotid intima-medial thickness ( CIMT ) and flow-mediated dilation ( FMD ) of the brachial artery measured and underwent an 18F-FDG PET scan . St and ardised uptake values ( SUV ) were measured at six sites in the carotid , femoral and aortic arteries . Areas of locally increased tracer uptake in the arterial wall ( ‘ hot spots ’ ) were also identified and counted . Results : Long-term B-vitamin treatment significantly reduced tHcy compared with placebo ( 8.4 μmol/l , 95 % confidence interval , CI , 7.2–9.6 vs. 11.6 μmol/l , 95 % CI 10.0–13.4 , p = 0.002 ) . The treatment did not affect mean arterial SUV ( 2.0 ± 0.3 vitamins vs. 2.1 ± 0.3 placebo , p = 0.65 ) or the number of hot spots ( n = 1.1 ± 1.0 vitamins vs. n = 1.2 ± 1.0 placebo , p = 0.65 ) . There was no significant correlation between mean arterial SUV and CIMT or FMD . Conclusions : These results suggest that a long-term Hcy reduction with B vitamins does not affect arterial wall inflammation assessed by 18F-FDG PET
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 .