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 .
Homocysteine-lowering therapy does not affect inflammatory markers of atherosclerosis in patients with stable coronary artery disease.
OBJECTIVES A high level of total homocysteine ( tHcy ) is a risk marker for cardiovascular disease ( CVD ) , and is related to inflammation . We wanted to test the effect of homocysteine-lowering B-vitamin therapy , as used in the Western Norway B-vitamin Intervention Trial ( WENBIT ) , on inflammatory markers associated with atherosclerosis . DESIGN Single centre , prospect i ve double-blind clinical interventional study , r and omised in a 2 x 2 factorial design . SUBJECTS AND METHODS Ninety patients ( 21 female ) with suspected coronary artery disease ( CAD ) , aged 38 - 80 years , were blindly r and omised into one of four groups of daily oral treatment with ( A ) folic acid ( 0.8 mg)/vitamin B12 ( 0.4 mg)/vitamin B6 ( 40 mg ) , ( B ) folic acid/vitamin B12 , ( C ) vitamin B6 alone or ( D ) placebo . Blood sample s were collected before and after 6 months of treatment . RESULTS Before intervention , median levels of the analytes were : tHcy 11.0 micromol L(-1 ) , neopterin 8.1 nmol L(-1 ) , soluble CD40 lig and ( sCD40L ) 3.9 ng mL(-1 ) , interleukin (IL)-6 1.9 pg mL(-1 ) , C-reactive protein ( CRP ) 1.9 mg L(-1 ) and low-density lipoprotein ( LDL ) cholesterol 3.3 mmol L(-1 ) . tHcy was significantly associated with neopterin ( r = 0.49 , P < 0.001 ) and with IL-6 ( r = 0.29 , P = 0.01 ) , but not with CRP or sCD40L . Neither treatment with folic acid/B12 nor with B6 induced significant changes in any of these inflammatory biomarkers ( P > or= 0.14 ) . In patients receiving folic acid/B12 ( groups A and B ) , tHcy was reduced with 33 % ( P < 0.001 ) . CONCLUSIONS In patients with stable CAD , homocysteine-lowering therapy with B-vitamins does not affect levels of inflammatory markers associated with atherogenesis . Failure to reverse inflammatory processes , may partly explain the negative results in clinical secondary B-vitamin intervention trials
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 .