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The effect of multiple micronutrient supplementation on left ventricular ejection fraction in patients with chronic stable heart failure: a randomized, placebo-controlled trial.
JACC Heart Fail. 2014 Jun; 2(3):308-17.JH

Abstract

OBJECTIVES

This study sought to investigate the effect of a multiple micronutrient supplement on left ventricular ejection fraction (LVEF) in patients with heart failure.

BACKGROUND

Observational studies suggest that patients with heart failure have reduced intake and lower concentrations of a number of micronutrients. However, there have been very few intervention studies investigating the effect of micronutrient supplementation in patients with heart failure.

METHODS

This was a randomized, double-blind, placebo-controlled, parallel-group study involving 74 patients with chronic stable heart failure that compared multiple micronutrient supplementation taken once daily versus placebo for 12 months. The primary endpoint was LVEF assessed by cardiovascular magnetic resonance imaging or 3-dimensional echocardiography. Secondary endpoints were Minnesota Living With Heart Failure Questionnaire score, 6-min walk test distance, blood concentrations of N-terminal prohormone of brain natriuretic peptide, C-reactive protein, tumor necrosis factor alpha, interleukin-6, interleukin-10, and urinary levels of 8-iso-prostaglandin F2 alpha.

RESULTS

Blood concentrations of a number of micronutrients increased significantly in the micronutrient supplement group, indicating excellent compliance with the intervention. There was no significant difference in mean LVEF at 12 months between treatment groups after adjusting for baseline (mean difference: 1.6%, 95% confidence interval: -2.6 to 5.8, p = 0.441). There was also no significant difference in any of the secondary endpoints at 12 months between treatment groups.

CONCLUSIONS

This study provides no evidence to support the routine treatment of patients with chronic stable heart failure with a multiple micronutrient supplement. (Micronutrient Supplementation in Patients With Heart Failure [MINT-HF]; NCT01005303).

Authors+Show Affiliations

Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland; The Heart Centre, Belfast Health & Social Care Trust, Belfast, Northern Ireland. Electronic address: nickmckeag@googlemail.com.Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.The Heart Centre, Belfast Health & Social Care Trust, Belfast, Northern Ireland; Centre for Medical Education, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland; The Heart Centre, Belfast Health & Social Care Trust, Belfast, Northern Ireland.The Heart Centre, Belfast Health & Social Care Trust, Belfast, Northern Ireland.Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.The Heart Centre, Belfast Health & Social Care Trust, Belfast, Northern Ireland; Centre for Medical Education, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24952700

Citation

McKeag, Nicholas A., et al. "The Effect of Multiple Micronutrient Supplementation On Left Ventricular Ejection Fraction in Patients With Chronic Stable Heart Failure: a Randomized, Placebo-controlled Trial." JACC. Heart Failure, vol. 2, no. 3, 2014, pp. 308-17.
McKeag NA, McKinley MC, Harbinson MT, et al. The effect of multiple micronutrient supplementation on left ventricular ejection fraction in patients with chronic stable heart failure: a randomized, placebo-controlled trial. JACC Heart Fail. 2014;2(3):308-17.
McKeag, N. A., McKinley, M. C., Harbinson, M. T., Noad, R. L., Dixon, L. H., McGinty, A., Neville, C. E., Woodside, J. V., & McKeown, P. P. (2014). The effect of multiple micronutrient supplementation on left ventricular ejection fraction in patients with chronic stable heart failure: a randomized, placebo-controlled trial. JACC. Heart Failure, 2(3), 308-17. https://doi.org/10.1016/j.jchf.2013.12.008
McKeag NA, et al. The Effect of Multiple Micronutrient Supplementation On Left Ventricular Ejection Fraction in Patients With Chronic Stable Heart Failure: a Randomized, Placebo-controlled Trial. JACC Heart Fail. 2014;2(3):308-17. PubMed PMID: 24952700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of multiple micronutrient supplementation on left ventricular ejection fraction in patients with chronic stable heart failure: a randomized, placebo-controlled trial. AU - McKeag,Nicholas A, AU - McKinley,Michelle C, AU - Harbinson,Mark T, AU - Noad,Rebecca L, AU - Dixon,Lynn H, AU - McGinty,Ann, AU - Neville,Charlotte E, AU - Woodside,Jayne V, AU - McKeown,Pascal P, PY - 2013/10/08/received PY - 2013/12/19/revised PY - 2013/12/24/accepted PY - 2014/6/23/entrez PY - 2014/6/24/pubmed PY - 2015/2/3/medline KW - heart failure KW - micronutrient KW - nutrition SP - 308 EP - 17 JF - JACC. Heart failure JO - JACC Heart Fail VL - 2 IS - 3 N2 - OBJECTIVES: This study sought to investigate the effect of a multiple micronutrient supplement on left ventricular ejection fraction (LVEF) in patients with heart failure. BACKGROUND: Observational studies suggest that patients with heart failure have reduced intake and lower concentrations of a number of micronutrients. However, there have been very few intervention studies investigating the effect of micronutrient supplementation in patients with heart failure. METHODS: This was a randomized, double-blind, placebo-controlled, parallel-group study involving 74 patients with chronic stable heart failure that compared multiple micronutrient supplementation taken once daily versus placebo for 12 months. The primary endpoint was LVEF assessed by cardiovascular magnetic resonance imaging or 3-dimensional echocardiography. Secondary endpoints were Minnesota Living With Heart Failure Questionnaire score, 6-min walk test distance, blood concentrations of N-terminal prohormone of brain natriuretic peptide, C-reactive protein, tumor necrosis factor alpha, interleukin-6, interleukin-10, and urinary levels of 8-iso-prostaglandin F2 alpha. RESULTS: Blood concentrations of a number of micronutrients increased significantly in the micronutrient supplement group, indicating excellent compliance with the intervention. There was no significant difference in mean LVEF at 12 months between treatment groups after adjusting for baseline (mean difference: 1.6%, 95% confidence interval: -2.6 to 5.8, p = 0.441). There was also no significant difference in any of the secondary endpoints at 12 months between treatment groups. CONCLUSIONS: This study provides no evidence to support the routine treatment of patients with chronic stable heart failure with a multiple micronutrient supplement. (Micronutrient Supplementation in Patients With Heart Failure [MINT-HF]; NCT01005303). SN - 2213-1787 UR - https://www.unboundmedicine.com/medline/citation/24952700/The_effect_of_multiple_micronutrient_supplementation_on_left_ventricular_ejection_fraction_in_patients_with_chronic_stable_heart_failure:_a_randomized_placebo_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-1779(14)00117-6 DB - PRIME DP - Unbound Medicine ER -