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A prospective study of folate and vitamin B6 and risk of myocardial infarction in US physicians.
J Am Coll Nutr 1996; 15(2):136-43JA

Abstract

OBJECTIVE

To assess prospectively the risk of myocardial infarction (MI) associated with decreased plasma levels of folate and pyridoxal phosphate (PLP, a form of vitamin B6) in relation to elevated levels of total homocysteine (tHcy).

DESIGN

Nested case-control study using prospectively collected blood samples.

SETTING

Participants in the Physicians' Health Study.

SUBJECTS

14,916 male physicians, aged 40-84 years, with no prior MI or stroke provided plasma samples at baseline and were followed for 7.5 years. Samples from 333 men who subsequently developed MI, and their paired controls matched by age and smoking, were analyzed for folate and PLP levels.

MEASURES OF OUTCOME

Acute MI or death due to coronary disease.

RESULTS

In a model controlling for diabetes, angina, hypertension, Quetelet's index, and total/high-density lipoprotein cholesterol, men with the lowest 20% of folate levels (< 2.0 ng/mL) had a relative risk of 1.4 (95% confidence interval 0.9-2.3) compared with those in the top 80%. For the lowest 20% of vitamin B6 values, the relative risk was 1.5 (95% CI: 1.0-2.2). When we included both folate and B6 in a model with cardiovascular risk factors, the relative risk of MI for low as compared to high levels of folate was 1.3 (95% CI: 0.8-2.1) and for PLP, 1.3 (95% CI: 0.9-2.1). Adding tHcy to this model did not add significant predictive value (chi sq = 2.0, p > 0.05), except in the first half of the follow-up interval when men with the top 5% of tHcy values had an almost three-fold increase in risk of MI.

CONCLUSIONS

Although not statistically significant, these prospective data are compatible with the hypothesis that low dietary intake of folate and/or vitamin B6 contribute to risk of MI.

Authors+Show Affiliations

Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

8778142

Citation

Chasan-Taber, L, et al. "A Prospective Study of Folate and Vitamin B6 and Risk of Myocardial Infarction in US Physicians." Journal of the American College of Nutrition, vol. 15, no. 2, 1996, pp. 136-43.
Chasan-Taber L, Selhub J, Rosenberg IH, et al. A prospective study of folate and vitamin B6 and risk of myocardial infarction in US physicians. J Am Coll Nutr. 1996;15(2):136-43.
Chasan-Taber, L., Selhub, J., Rosenberg, I. H., Malinow, M. R., Terry, P., Tishler, P. V., ... Stampfer, M. J. (1996). A prospective study of folate and vitamin B6 and risk of myocardial infarction in US physicians. Journal of the American College of Nutrition, 15(2), pp. 136-43.
Chasan-Taber L, et al. A Prospective Study of Folate and Vitamin B6 and Risk of Myocardial Infarction in US Physicians. J Am Coll Nutr. 1996;15(2):136-43. PubMed PMID: 8778142.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of folate and vitamin B6 and risk of myocardial infarction in US physicians. AU - Chasan-Taber,L, AU - Selhub,J, AU - Rosenberg,I H, AU - Malinow,M R, AU - Terry,P, AU - Tishler,P V, AU - Willett,W, AU - Hennekens,C H, AU - Stampfer,M J, PY - 1996/4/1/pubmed PY - 1996/4/1/medline PY - 1996/4/1/entrez SP - 136 EP - 43 JF - Journal of the American College of Nutrition JO - J Am Coll Nutr VL - 15 IS - 2 N2 - OBJECTIVE: To assess prospectively the risk of myocardial infarction (MI) associated with decreased plasma levels of folate and pyridoxal phosphate (PLP, a form of vitamin B6) in relation to elevated levels of total homocysteine (tHcy). DESIGN: Nested case-control study using prospectively collected blood samples. SETTING: Participants in the Physicians' Health Study. SUBJECTS: 14,916 male physicians, aged 40-84 years, with no prior MI or stroke provided plasma samples at baseline and were followed for 7.5 years. Samples from 333 men who subsequently developed MI, and their paired controls matched by age and smoking, were analyzed for folate and PLP levels. MEASURES OF OUTCOME: Acute MI or death due to coronary disease. RESULTS: In a model controlling for diabetes, angina, hypertension, Quetelet's index, and total/high-density lipoprotein cholesterol, men with the lowest 20% of folate levels (< 2.0 ng/mL) had a relative risk of 1.4 (95% confidence interval 0.9-2.3) compared with those in the top 80%. For the lowest 20% of vitamin B6 values, the relative risk was 1.5 (95% CI: 1.0-2.2). When we included both folate and B6 in a model with cardiovascular risk factors, the relative risk of MI for low as compared to high levels of folate was 1.3 (95% CI: 0.8-2.1) and for PLP, 1.3 (95% CI: 0.9-2.1). Adding tHcy to this model did not add significant predictive value (chi sq = 2.0, p > 0.05), except in the first half of the follow-up interval when men with the top 5% of tHcy values had an almost three-fold increase in risk of MI. CONCLUSIONS: Although not statistically significant, these prospective data are compatible with the hypothesis that low dietary intake of folate and/or vitamin B6 contribute to risk of MI. SN - 0731-5724 UR - https://www.unboundmedicine.com/medline/citation/8778142/A_prospective_study_of_folate_and_vitamin_B6_and_risk_of_myocardial_infarction_in_US_physicians_ L2 - http://www.tandfonline.com/doi/full/10.1080/07315724.1996.10718578 DB - PRIME DP - Unbound Medicine ER -