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【JAMA】B族维生素无法减少冠心病患者死亡或心血
abstract:
Context Observational studies have reported associations between circulating total homocysteine concentration and risk of cardiovascular disease. Oral administration of folic acid and vitamin B12 can lower plasma total homocysteine levels.
Objective To assess the effect of treatment with folic acid and vitamin B12 and the effect of treatment with vitamin B6 as secondary prevention in patients with coronary artery disease or aortic valve stenosis.
Design, Setting, and Participants Randomized, double-blind controlled trial conducted in the 2 university hospitals in western Norway in 1999-2006. A total of 3096 adult participants undergoing coronary angiography (20.5% female; mean age, 61.7 years) were randomized. At baseline, 59.3% had double- or triple-vessel disease, 83.7% had stable angina pectoris, and 14.9% had acute coronary syndromes.
Interventions Using a 2 x 2 factorial design, participants were randomly assigned to 1 of 4 groups receiving daily oral treatment with folic acid, 0.8 mg, plus vitamin B12, 0.4 mg, plus vitamin B6, 40 mg (n = 772); folic acid plus vitamin B12 (n = 772); vitamin B6 alone (n = 772); or placebo (n = 780).
Main Outcome Measures The primary end point was a composite of all-cause death, nonfatal acute myocardial infarction, acute hospitalization for unstable angina pectoris, and nonfatal thromboembolic stroke.
Results Mean plasma total homocysteine concentration was reduced by 30% after 1 year of treatment in the groups receiving folic acid and vitamin B12. The trial was terminated early because of concern among participants due to preliminary results from a contemporaneous Norwegian trial suggesting adverse effects from the intervention. During a median 38 months of follow-up, the primary end point was experienced by a total of 422 participants (13.7%): 219 participants (14.2%) receiving folic acid/vitamin B12 vs 203 (13.1%) not receiving such treatment (hazard ratio, 1.09; 95% confidence interval, 0.90-1.32; P = .36) and 200 participants (13.0%) receiving vitamin B6 vs 222 (14.3%) not receiving vitamin B6 (hazard ratio, 0.90; 95% confidence interval, 0.74-1.09; P = .28).
Conclusions This trial did not find an effect of treatment with folic acid/vitamin B12 or vitamin B6 on total mortality or cardiovascular events. Our findings do not support the use of B vitamins as secondary prevention in patients with coronary artery disease.
来源：
http://jama.ama-assn.org/cgi/content/full/300/7/795 本人已认领该文章编译 48小时如未提交 请其它战友自由认领 title:Mortality and Cardiovascular Events in Patients Treated With Homocysteine-Lowering B Vitamins After Coronary Angiography
接受冠状动脉造影术后用高半胱氨酸降低的维生素b治疗的人群的死亡率和心血管事件发生率
abstract:
Context Observational studies have reported associations between circulating total homocysteine concentration and risk of cardiovascular disease. Oral administration of folic acid and vitamin B12 can lower plasma total homocysteine levels.
摘要 研究背景 研究报道伴随循环中总高半胱氨酸浓度和心血管疾病风险之间的关系。口服叶酸和维生素B12可以降低血浆中总高半胱氨酸的水平。
Objective To assess the effect of treatment with folic acid and vitamin B12 and the effect of treatment with vitamin B6 as secondary prevention in patients with coronary artery disease or aortic valve stenosis.
试验目的 评估在冠心病或主动脉瓣狭窄的患者中作为2级保护的叶酸、维生素B12、维生素B6的效果。
Design, Setting, and Participants Randomized, double-blind controlled trial conducted in the 2 university hospitals in western Norway in 1999-2006. A total of 3096 adult participants undergoing coronary angiography (20.5% female; mean age, 61.7 years) were randomized. At baseline, 59.3% had double- or triple-vessel disease, 83.7% had stable angina pectoris, and 14.9% had acute coronary syndromes.
试验在挪威西部的2家大学医院，设计、设定、随机化被试验者、双盲对照试验。总数为3096名接受冠状动脉造影的成年人（20.5%女性，平均年龄61.7岁）被随机化分组。基线为59.3%的患者有2支或3支血管病变，83.7%患稳定型心绞痛，14.9%有急性冠脉综合症。
Interventions Using a 2 x 2 factorial design, participants were randomly assigned to 1 of 4 groups receiving daily oral treatment with folic acid, 0.8 mg, plus vitamin B12, 0.4 mg, plus vitamin B6, 40 mg (n = 772); folic acid plus vitamin B12 (n = 772); vitamin B6 alone (n = 772); or placebo (n = 780).
干涉采用2 x 2析因设计，患者被随机指定到1—4组每日接受口服叶酸0.8mg，及维生素B12，0.4mg及维生素B6，40mg（n人数= 772);叶酸加维生素B12组(n = 772)；单用维生素B6组 (n = 772) 对照组(n = 780).
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作者:admin@医学,生命科学 2011-04-06 14:04
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