Folic acid supplementation with and without vitamin B6 and revascularization risk: A meta-analysis of randomized controlled trials

Xianhui Qin, Fangfang Fan, Yimin Cui, Fang Chen, Yundai Chen, Xiaoshu Cheng, Yuming Li, Binyan Wang, Xin Xu, Xiping Xu, Yong Huo, Xiaobin Wang

Research output: Contribution to journalArticle

Abstract

Background & aims: There is a growing amount of data and a continuing controversy over the effect of folic acid supplementation with and without vitamin B6 on revascularization risk. Methods: We conducted a meta-analysis based on up-to-date published relevant randomized trials to further examine this issue. Relative risk (RR) was used to measure the effect of folic acid supplementation on risk of revascularization using a random-effects model. Total revascularization was defined as any arterial revascularization. Restenosis was defined as stenosis of more than 50 percent of the luminal diameter. Results: Overall, folic acid supplementation had no significant effect on coronary revascularization (9 trials, n=27,418, RR=0.99; 95%CI:0.88-1.11, P=0.88), coronary artery bypass grafting (CABG) (5 trials, n=10,703, 0.90; 0.79-1.03, P=0.11), percutaneous coronary intervention (PCI) (5 trials, n=10,703, 1.05; 0.89-1.23, P=0.59), coronary restenosis (3 trials, n=926, 1.05; 0.89-1.23, P=0.59) or total revascularization (7 trials, n=29,314, 1.06; 95%CI: 0.99-1.13, P=0.10). However, a greater beneficial effect was observed for coronary revascularization among those trials with a moderate dose of vitamin B6 (5-10mg/d; RR: 0.47; 95%CI: 0.28-0.80, P=0.005), but not in trials without vitamin B6 or with a high dose of vitamin B6. And a non-significant greater total revascularization risk was observed in trials with a higher folic acid dose (>2mg/d, RR=1.11; 95%CI: 0.98-1.25, P=0.09; ≥5mg/d, RR=1.98; 95%CI: 0.93-4.20, P=0.08). Conclusions: Our analyses indicate that folic acid supplementation has no significant effect on coronary revascularization, CABG, PCI, coronary restenosis or total revascularization. However, a combination of folic acid and moderate vitamin B6 may be beneficial in reducing coronary revascularization risk.

Original languageEnglish (US)
Pages (from-to)603-612
Number of pages10
JournalClinical Nutrition
Volume33
Issue number4
DOIs
StatePublished - 2014

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Vitamin B 6
Folic Acid
Meta-Analysis
Randomized Controlled Trials
Coronary Restenosis
Percutaneous Coronary Intervention
Coronary Artery Bypass
Pathologic Constriction

Keywords

  • Folic acid supplementation
  • Meta-analysis
  • Randomized controlled trials
  • Revascularization risk

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nutrition and Dietetics
  • Medicine(all)

Cite this

Folic acid supplementation with and without vitamin B6 and revascularization risk : A meta-analysis of randomized controlled trials. / Qin, Xianhui; Fan, Fangfang; Cui, Yimin; Chen, Fang; Chen, Yundai; Cheng, Xiaoshu; Li, Yuming; Wang, Binyan; Xu, Xin; Xu, Xiping; Huo, Yong; Wang, Xiaobin.

In: Clinical Nutrition, Vol. 33, No. 4, 2014, p. 603-612.

Research output: Contribution to journalArticle

Qin, Xianhui ; Fan, Fangfang ; Cui, Yimin ; Chen, Fang ; Chen, Yundai ; Cheng, Xiaoshu ; Li, Yuming ; Wang, Binyan ; Xu, Xin ; Xu, Xiping ; Huo, Yong ; Wang, Xiaobin. / Folic acid supplementation with and without vitamin B6 and revascularization risk : A meta-analysis of randomized controlled trials. In: Clinical Nutrition. 2014 ; Vol. 33, No. 4. pp. 603-612.
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abstract = "Background & aims: There is a growing amount of data and a continuing controversy over the effect of folic acid supplementation with and without vitamin B6 on revascularization risk. Methods: We conducted a meta-analysis based on up-to-date published relevant randomized trials to further examine this issue. Relative risk (RR) was used to measure the effect of folic acid supplementation on risk of revascularization using a random-effects model. Total revascularization was defined as any arterial revascularization. Restenosis was defined as stenosis of more than 50 percent of the luminal diameter. Results: Overall, folic acid supplementation had no significant effect on coronary revascularization (9 trials, n=27,418, RR=0.99; 95{\%}CI:0.88-1.11, P=0.88), coronary artery bypass grafting (CABG) (5 trials, n=10,703, 0.90; 0.79-1.03, P=0.11), percutaneous coronary intervention (PCI) (5 trials, n=10,703, 1.05; 0.89-1.23, P=0.59), coronary restenosis (3 trials, n=926, 1.05; 0.89-1.23, P=0.59) or total revascularization (7 trials, n=29,314, 1.06; 95{\%}CI: 0.99-1.13, P=0.10). However, a greater beneficial effect was observed for coronary revascularization among those trials with a moderate dose of vitamin B6 (5-10mg/d; RR: 0.47; 95{\%}CI: 0.28-0.80, P=0.005), but not in trials without vitamin B6 or with a high dose of vitamin B6. And a non-significant greater total revascularization risk was observed in trials with a higher folic acid dose (>2mg/d, RR=1.11; 95{\%}CI: 0.98-1.25, P=0.09; ≥5mg/d, RR=1.98; 95{\%}CI: 0.93-4.20, P=0.08). Conclusions: Our analyses indicate that folic acid supplementation has no significant effect on coronary revascularization, CABG, PCI, coronary restenosis or total revascularization. However, a combination of folic acid and moderate vitamin B6 may be beneficial in reducing coronary revascularization risk.",
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T2 - A meta-analysis of randomized controlled trials

AU - Qin, Xianhui

AU - Fan, Fangfang

AU - Cui, Yimin

AU - Chen, Fang

AU - Chen, Yundai

AU - Cheng, Xiaoshu

AU - Li, Yuming

AU - Wang, Binyan

AU - Xu, Xin

AU - Xu, Xiping

AU - Huo, Yong

AU - Wang, Xiaobin

PY - 2014

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N2 - Background & aims: There is a growing amount of data and a continuing controversy over the effect of folic acid supplementation with and without vitamin B6 on revascularization risk. Methods: We conducted a meta-analysis based on up-to-date published relevant randomized trials to further examine this issue. Relative risk (RR) was used to measure the effect of folic acid supplementation on risk of revascularization using a random-effects model. Total revascularization was defined as any arterial revascularization. Restenosis was defined as stenosis of more than 50 percent of the luminal diameter. Results: Overall, folic acid supplementation had no significant effect on coronary revascularization (9 trials, n=27,418, RR=0.99; 95%CI:0.88-1.11, P=0.88), coronary artery bypass grafting (CABG) (5 trials, n=10,703, 0.90; 0.79-1.03, P=0.11), percutaneous coronary intervention (PCI) (5 trials, n=10,703, 1.05; 0.89-1.23, P=0.59), coronary restenosis (3 trials, n=926, 1.05; 0.89-1.23, P=0.59) or total revascularization (7 trials, n=29,314, 1.06; 95%CI: 0.99-1.13, P=0.10). However, a greater beneficial effect was observed for coronary revascularization among those trials with a moderate dose of vitamin B6 (5-10mg/d; RR: 0.47; 95%CI: 0.28-0.80, P=0.005), but not in trials without vitamin B6 or with a high dose of vitamin B6. And a non-significant greater total revascularization risk was observed in trials with a higher folic acid dose (>2mg/d, RR=1.11; 95%CI: 0.98-1.25, P=0.09; ≥5mg/d, RR=1.98; 95%CI: 0.93-4.20, P=0.08). Conclusions: Our analyses indicate that folic acid supplementation has no significant effect on coronary revascularization, CABG, PCI, coronary restenosis or total revascularization. However, a combination of folic acid and moderate vitamin B6 may be beneficial in reducing coronary revascularization risk.

AB - Background & aims: There is a growing amount of data and a continuing controversy over the effect of folic acid supplementation with and without vitamin B6 on revascularization risk. Methods: We conducted a meta-analysis based on up-to-date published relevant randomized trials to further examine this issue. Relative risk (RR) was used to measure the effect of folic acid supplementation on risk of revascularization using a random-effects model. Total revascularization was defined as any arterial revascularization. Restenosis was defined as stenosis of more than 50 percent of the luminal diameter. Results: Overall, folic acid supplementation had no significant effect on coronary revascularization (9 trials, n=27,418, RR=0.99; 95%CI:0.88-1.11, P=0.88), coronary artery bypass grafting (CABG) (5 trials, n=10,703, 0.90; 0.79-1.03, P=0.11), percutaneous coronary intervention (PCI) (5 trials, n=10,703, 1.05; 0.89-1.23, P=0.59), coronary restenosis (3 trials, n=926, 1.05; 0.89-1.23, P=0.59) or total revascularization (7 trials, n=29,314, 1.06; 95%CI: 0.99-1.13, P=0.10). However, a greater beneficial effect was observed for coronary revascularization among those trials with a moderate dose of vitamin B6 (5-10mg/d; RR: 0.47; 95%CI: 0.28-0.80, P=0.005), but not in trials without vitamin B6 or with a high dose of vitamin B6. And a non-significant greater total revascularization risk was observed in trials with a higher folic acid dose (>2mg/d, RR=1.11; 95%CI: 0.98-1.25, P=0.09; ≥5mg/d, RR=1.98; 95%CI: 0.93-4.20, P=0.08). Conclusions: Our analyses indicate that folic acid supplementation has no significant effect on coronary revascularization, CABG, PCI, coronary restenosis or total revascularization. However, a combination of folic acid and moderate vitamin B6 may be beneficial in reducing coronary revascularization risk.

KW - Folic acid supplementation

KW - Meta-analysis

KW - Randomized controlled trials

KW - Revascularization risk

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