TY - JOUR
T1 - Folic acid supplementation with and without vitamin B6 and revascularization risk
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
N1 - Funding Information:
The study was supported by the Major State Basic Research Development Program of China (973 program, No. 2012CB517703 ); and the Ministry of Science and Technology of the People's Republic of China ( 2012zx09101-105 ). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
PY - 2014/8
Y1 - 2014/8
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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U2 - 10.1016/j.clnu.2014.01.006
DO - 10.1016/j.clnu.2014.01.006
M3 - Article
C2 - 24461473
AN - SCOPUS:84902381890
SN - 0261-5614
VL - 33
SP - 603
EP - 612
JO - Clinical Nutrition
JF - Clinical Nutrition
IS - 4
ER -