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Efficacy of Supplementation with B Vitamins for Stroke Prevention: A Network Meta-Analysis of Randomized Controlled Trials.
PLoS One 2015; 10(9):e0137533Plos

Abstract

BACKGROUND

Supplementation with B vitamins for stroke prevention has been evaluated over the years, but which combination of B vitamins is optimal for stroke prevention is unclear. We performed a network meta-analysis to assess the impact of different combinations of B vitamins on risk of stroke.

METHODS

A total of 17 trials (86 393 patients) comparing 7 treatment strategies and placebo were included. A network meta-analysis combined all available direct and indirect treatment comparisons to evaluate the efficacy of B vitamin supplementation for all interventions.

RESULTS

B vitamin supplementation was associated with reduced risk of stroke and cerebral hemorrhage. The risk of stroke was lower with folic acid plus vitamin B6 as compared with folic acid plus vitamin B12 and was lower with folic acid plus vitamin B6 plus vitamin B12 as compared with placebo or folic acid plus vitamin B12. The treatments ranked in order of efficacy for stroke, from higher to lower, were folic acid plus vitamin B6 > folic acid > folic acid plus vitamin B6 plus vitamin B12 > vitamin B6 plus vitamin B12 > niacin > vitamin B6 > placebo > folic acid plus vitamin B12.

CONCLUSIONS

B vitamin supplementation was associated with reduced risk of stroke; different B vitamins and their combined treatments had different efficacy on stroke prevention. Folic acid plus vitamin B6 might be the optimal therapy for stroke prevention. Folic acid and vitamin B6 were both valuable for stroke prevention. The efficacy of vitamin B12 remains to be studied.

Authors+Show Affiliations

Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, China.Department of Sports, Shantou University Medical College, Shantou, Guangdong, China.Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, China.Department of Neurology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, China.Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, China.Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, China.

Pub Type(s)

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

Language

eng

PubMed ID

26355679

Citation

Dong, Hongli, et al. "Efficacy of Supplementation With B Vitamins for Stroke Prevention: a Network Meta-Analysis of Randomized Controlled Trials." PloS One, vol. 10, no. 9, 2015, pp. e0137533.
Dong H, Pi F, Ding Z, et al. Efficacy of Supplementation with B Vitamins for Stroke Prevention: A Network Meta-Analysis of Randomized Controlled Trials. PLoS ONE. 2015;10(9):e0137533.
Dong, H., Pi, F., Ding, Z., Chen, W., Pang, S., Dong, W., & Zhang, Q. (2015). Efficacy of Supplementation with B Vitamins for Stroke Prevention: A Network Meta-Analysis of Randomized Controlled Trials. PloS One, 10(9), pp. e0137533. doi:10.1371/journal.pone.0137533.
Dong H, et al. Efficacy of Supplementation With B Vitamins for Stroke Prevention: a Network Meta-Analysis of Randomized Controlled Trials. PLoS ONE. 2015;10(9):e0137533. PubMed PMID: 26355679.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of Supplementation with B Vitamins for Stroke Prevention: A Network Meta-Analysis of Randomized Controlled Trials. AU - Dong,Hongli, AU - Pi,Fuhua, AU - Ding,Zan, AU - Chen,Wei, AU - Pang,Shaojie, AU - Dong,Wenya, AU - Zhang,Qingying, Y1 - 2015/09/10/ PY - 2015/04/25/received PY - 2015/08/18/accepted PY - 2015/9/11/entrez PY - 2015/9/12/pubmed PY - 2016/5/25/medline SP - e0137533 EP - e0137533 JF - PloS one JO - PLoS ONE VL - 10 IS - 9 N2 - BACKGROUND: Supplementation with B vitamins for stroke prevention has been evaluated over the years, but which combination of B vitamins is optimal for stroke prevention is unclear. We performed a network meta-analysis to assess the impact of different combinations of B vitamins on risk of stroke. METHODS: A total of 17 trials (86 393 patients) comparing 7 treatment strategies and placebo were included. A network meta-analysis combined all available direct and indirect treatment comparisons to evaluate the efficacy of B vitamin supplementation for all interventions. RESULTS: B vitamin supplementation was associated with reduced risk of stroke and cerebral hemorrhage. The risk of stroke was lower with folic acid plus vitamin B6 as compared with folic acid plus vitamin B12 and was lower with folic acid plus vitamin B6 plus vitamin B12 as compared with placebo or folic acid plus vitamin B12. The treatments ranked in order of efficacy for stroke, from higher to lower, were folic acid plus vitamin B6 > folic acid > folic acid plus vitamin B6 plus vitamin B12 > vitamin B6 plus vitamin B12 > niacin > vitamin B6 > placebo > folic acid plus vitamin B12. CONCLUSIONS: B vitamin supplementation was associated with reduced risk of stroke; different B vitamins and their combined treatments had different efficacy on stroke prevention. Folic acid plus vitamin B6 might be the optimal therapy for stroke prevention. Folic acid and vitamin B6 were both valuable for stroke prevention. The efficacy of vitamin B12 remains to be studied. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/26355679/Efficacy_of_Supplementation_with_B_Vitamins_for_Stroke_Prevention:_A_Network_Meta_Analysis_of_Randomized_Controlled_Trials_ L2 - http://dx.plos.org/10.1371/journal.pone.0137533 DB - PRIME DP - Unbound Medicine ER -