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Association between B vitamins supplementation and risk of cardiovascular outcomes: a cumulative meta-analysis of randomized controlled trials.
PLoS One 2014; 9(9):e107060Plos

Abstract

BACKGROUND

Observational studies suggest that B vitamin supplementation reduces cardiovascular risk in adults, but this association remains controversial. This study aimed to summarize the evidence from randomized controlled trials (RCTs) investigating B vitamin supplementation for the primary or secondary prevention of major adverse cardiovascular outcomes and to perform a cumulative meta-analysis to determine the evidence base.

METHODOLOGY AND PRINCIPAL FINDINGS

In April 2013, we searched PubMed, Embase, and the Cochrane Library to identify relevant RCTs. We included RCTs investigating the effect of B vitamin supplementation on cardiovascular outcome. Relative risk (RR) was used to measure the effect using a random-effect model. Statistical heterogeneity scores were assessed using the Q statistic. We included data on 57,952 individuals from 24 RCTs: 12 primary prevention trials and 12 secondary prevention trials. In 23 of these trials, 10,917 major adverse cardiovascular events (MACE) occurred; in 20 trials, 7,203 deaths occurred; in 15 trials, 3,422 cardiac deaths occurred; in 19 trials, 3,623 myocardial infarctions (MI) occurred; and in 18 trials, 2,465 strokes occurred. B vitamin supplementation had little or no effect on the incidence of MACE (RR, 0.98; 95% confidence interval [CI]: 0.93-1.03; P = 0.37), total mortality (RR, 1.01; 95% CI: 0.97-1.05; P = 0.77), cardiac death (RR, 0.96; 95% CI: 0.90-1.02; P = 0.21), MI (RR, 0.99; 95% CI: 0.93-1.06; P = 0.82), or stroke (RR, 0.94; 95% CI: 0.85-1.03; P = 0.18).

CONCLUSION/SIGNIFICANCE

B vitamin supplementation, when used for primary or secondary prevention, is not associated with a reduction in MACE, total mortality, cardiac death, MI, or stroke.

Authors+Show Affiliations

Department of Neurosurgery, Shanghai Seventh People's Hospital, Shanghai, China.Department of Information, Changhai Hospital, Second Military Medical University, Shanghai, China.Department of Health Statistics, Second Military Medical University, Shanghai, China.Department of Health Statistics, Second Military Medical University, Shanghai, China.Department of Rehabilitation Institute, Shanghai Seventh People's Hospital, Shanghai, China.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25238614

Citation

Zhang, Chi, et al. "Association Between B Vitamins Supplementation and Risk of Cardiovascular Outcomes: a Cumulative Meta-analysis of Randomized Controlled Trials." PloS One, vol. 9, no. 9, 2014, pp. e107060.
Zhang C, Wang ZY, Qin YY, et al. Association between B vitamins supplementation and risk of cardiovascular outcomes: a cumulative meta-analysis of randomized controlled trials. PLoS ONE. 2014;9(9):e107060.
Zhang, C., Wang, Z. Y., Qin, Y. Y., Yu, F. F., & Zhou, Y. H. (2014). Association between B vitamins supplementation and risk of cardiovascular outcomes: a cumulative meta-analysis of randomized controlled trials. PloS One, 9(9), pp. e107060. doi:10.1371/journal.pone.0107060.
Zhang C, et al. Association Between B Vitamins Supplementation and Risk of Cardiovascular Outcomes: a Cumulative Meta-analysis of Randomized Controlled Trials. PLoS ONE. 2014;9(9):e107060. PubMed PMID: 25238614.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between B vitamins supplementation and risk of cardiovascular outcomes: a cumulative meta-analysis of randomized controlled trials. AU - Zhang,Chi, AU - Wang,Zhi-Yong, AU - Qin,Ying-Yi, AU - Yu,Fei-Fei, AU - Zhou,Yu-Hao, Y1 - 2014/09/19/ PY - 2014/05/11/received PY - 2014/08/06/accepted PY - 2014/9/20/entrez PY - 2014/9/23/pubmed PY - 2015/6/17/medline SP - e107060 EP - e107060 JF - PloS one JO - PLoS ONE VL - 9 IS - 9 N2 - BACKGROUND: Observational studies suggest that B vitamin supplementation reduces cardiovascular risk in adults, but this association remains controversial. This study aimed to summarize the evidence from randomized controlled trials (RCTs) investigating B vitamin supplementation for the primary or secondary prevention of major adverse cardiovascular outcomes and to perform a cumulative meta-analysis to determine the evidence base. METHODOLOGY AND PRINCIPAL FINDINGS: In April 2013, we searched PubMed, Embase, and the Cochrane Library to identify relevant RCTs. We included RCTs investigating the effect of B vitamin supplementation on cardiovascular outcome. Relative risk (RR) was used to measure the effect using a random-effect model. Statistical heterogeneity scores were assessed using the Q statistic. We included data on 57,952 individuals from 24 RCTs: 12 primary prevention trials and 12 secondary prevention trials. In 23 of these trials, 10,917 major adverse cardiovascular events (MACE) occurred; in 20 trials, 7,203 deaths occurred; in 15 trials, 3,422 cardiac deaths occurred; in 19 trials, 3,623 myocardial infarctions (MI) occurred; and in 18 trials, 2,465 strokes occurred. B vitamin supplementation had little or no effect on the incidence of MACE (RR, 0.98; 95% confidence interval [CI]: 0.93-1.03; P = 0.37), total mortality (RR, 1.01; 95% CI: 0.97-1.05; P = 0.77), cardiac death (RR, 0.96; 95% CI: 0.90-1.02; P = 0.21), MI (RR, 0.99; 95% CI: 0.93-1.06; P = 0.82), or stroke (RR, 0.94; 95% CI: 0.85-1.03; P = 0.18). CONCLUSION/SIGNIFICANCE: B vitamin supplementation, when used for primary or secondary prevention, is not associated with a reduction in MACE, total mortality, cardiac death, MI, or stroke. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/25238614/Association_between_B_vitamins_supplementation_and_risk_of_cardiovascular_outcomes:_a_cumulative_meta_analysis_of_randomized_controlled_trials_ L2 - http://dx.plos.org/10.1371/journal.pone.0107060 DB - PRIME DP - Unbound Medicine ER -