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 .
Treatment With B Vitamins and Incidence of Cancer in Patients With Previous Stroke or Transient Ischemic Attack: Results of a Randomized Placebo-Controlled Trial
Background and Purpose — To determine the effect of B vitamin treatment on the incidence of cancer among patients with stroke or transient ischemic attack . Methods — A total of 8164 patients with recent stroke or transient ischemic attack were r and omly allocated to double-blind treatment with 1 tablet daily of placebo or B vitamins ( 2 mg folic acid , 25 mg vitamin B6 , 500 & mgr;g vitamin B12 ) and followed for a median of 3.4 years for any cancer as an adverse event . Results — There was no significant difference in the incidence of any cancer among participants assigned B vitamins compared with placebo ( 4.04 % versus 4.59 % ; risk ratio , 0.86 ; 95 % CI , 0.70–1.07 ) and no difference in cancer mortality ( 2.35 % versus 2.09 % ; risk ratio , 1.09 ; 0.81–1.46 ) . Among 1899 patients with diabetes , the incidence of cancer was higher among participants assigned B vitamins compared with placebo ( 5.35 % versus 3.28 % ; adjusted risk ratio , 2.21 ; 1.31–3.73 ) , whereas among 6168 patients without diabetes , the incidence of cancer was lower among participants assigned B vitamins compared with placebo ( 3.66 % versus 5.03 % ; adjusted risk ratio , 0.67 ; 0.51–0.87 ; P for interaction=0.0001 ) . Conclusions — Daily administration of folic acid , vitamin B6 , and vitamin B12 to 8164 patients with recent stroke or transient ischemic attack for a median of 3.4 years had no significant effect , compared with placebo , on cancer incidence or mortality . However , a post hoc subgroup analysis raises the hypothesis that folic acid treatment may increase the incidence of cancer among diabetics and reduce the incidence of cancer among nondiabetics with a history of stroke or transient ischemic attack . Clinical Trial Registration — URL : www . clinical trials.gov . Unique identifier : NCT00097669 . URL : www.controlled-trials.com . Unique identifier : IS RCT N74743444
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 .