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Homocysteine-lowering interventions for preventing cardiovascular events
Arturo J Martí-Carvajal1, Ivan Solà, Dimitrios Lathyris
1Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, Ecuador. arturo.marti.carvajal@gmail.com.
The Cochrane Database of Systematic Reviews
|February 27, 2013
Summary
Homocysteine-lowering interventions using vitamin supplements do not prevent cardiovascular events. This updated review found no evidence of benefit for preventing heart attacks, strokes, or death, nor an increased cancer risk.
Area of Science:
- Cardiovascular health
- Nutritional science
- Medical research
Background:
- Cardiovascular disease is a leading global cause of death.
- Elevated homocysteine levels are a postulated risk factor for cardiovascular events.
- This review updates previous findings from 2009.
Purpose of the Study:
- To assess the clinical effectiveness of homocysteine-lowering interventions.
- To evaluate these interventions in individuals with and without pre-existing cardiovascular disease.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) with follow-up of at least one year.
- Searched multiple databases including CENTRAL, MEDLINE, EMBASE, LILACS, and ISI Web of Science.
- Included 12 RCTs with 47,429 participants, assessing myocardial infarction, stroke, and all-cause mortality.
Main Results:
- Homocysteine-lowering interventions did not significantly reduce non-fatal or fatal myocardial infarction (RR 1.02, 95% CI 0.95 to 1.10).
- No significant effect was observed on stroke incidence (RR 0.91, 95% CI 0.82 to 1.0) or all-cause mortality (RR 1.01, 95% CI 0.96 to 1.07).
- No significant increase in serious adverse events, including cancer, was associated with these interventions (RR 1.06, 95% CI 0.98 to 1.13).
Conclusions:
- Current evidence does not support the use of homocysteine-lowering interventions (vitamin B6, B9, B12 supplements) for cardiovascular event prevention.
- No evidence suggests these interventions increase cancer risk.
- Further research may be needed to clarify the role of homocysteine in cardiovascular health.
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