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Efectos de la suplementación de vitamina E a largo plazo en eventos cardiovasculares y cáncer: un ensayo clínico
Eva Lonn1, Jackie Bosch, Salim Yusuf
1Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario.
JAMA
|March 17, 2005
Resumen
La suplementación de vitamina E a largo plazo no evitó el cáncer o los eventos cardiovasculares en pacientes con enfermedad vascular o diabetes. El estudio encontró un mayor riesgo de insuficiencia cardíaca con el uso de vitamina E.
Área de la Ciencia:
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Oncología Oncología.
- Ciencias de la Nutrición Ciencias de la Nutrición
Sus antecedentes:
- Investigaciones anteriores sugirieron que la vitamina E podría prevenir el cáncer y los eventos cardiovasculares.
- Los ensayos clínicos a menudo no han podido confirmar estos beneficios, posiblemente debido a una duración insuficiente.
Objetivo del estudio:
- Evaluar si la suplementación de vitamina E a largo plazo reduce el riesgo de cáncer, la mortalidad por cáncer y los principales eventos cardiovasculares.
- Para evaluar los efectos a largo plazo de la vitamina E en pacientes con enfermedad vascular existente o diabetes mellitus.
Principales métodos:
- Un ensayo aleatorizado, doble ciego y controlado con placebo (HOPE-TOO) extendió el ensayo inicial HOPE.
- Los participantes (n=7030) recibieron diariamente vitamina E (400 UI) o placebo, con una mediana de seguimiento de 7.0 años.
- Los resultados primarios incluyeron incidencia/mortalidad por cáncer y eventos cardiovasculares importantes; los resultados secundarios incluyeron insuficiencia cardíaca.
Principales resultados:
- No se observaron diferencias significativas entre los grupos de vitamina E y placebo en cuanto a la incidencia del cáncer (11,6% frente a 12,3%), las muertes por cáncer (3,3% frente a 3,7%) o los eventos cardiovasculares importantes (21,5% frente a 20,6%).
- Los pacientes que recibieron vitamina E mostraron un riesgo estadísticamente significativo más alto de insuficiencia cardíaca (RR, 1.13; P = .03) y hospitalización por insuficiencia cardíaca (RR, 1.21; P = .045).
- Estos hallazgos fueron consistentes tanto en la población general del ensayo HOPE como en el subconjunto que participó en la extensión HOPE-TOO.
Conclusiones:
- La suplementación de vitamina E a largo plazo (400 UI diarias) es ineficaz para prevenir el cáncer o los eventos cardiovasculares importantes en personas con enfermedad vascular o diabetes.
- La suplementación de vitamina E puede estar asociada con un mayor riesgo de insuficiencia cardíaca en esta población de pacientes.
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