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Journal ArticleDOI

Homocysteine Lowering with Folic Acid and B Vitamins in Vascular Disease

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TLDR
Supplements combining folic acid and vitamins B6 and B12 did not reduce the risk of major cardiovascular events in patients with vascular disease.
Abstract
risk, 0.95; 95 percent confidence interval, 0.84 to 1.07; P = 0.41). As compared with placebo, active treatment did not significantly decrease the risk of death from cardiovascular causes (relative risk, 0.96; 95 percent confidence interval, 0.81 to 1.13), myocardial infarction (relative risk, 0.98; 95 percent confidence interval, 0.85 to 1.14), or any of the secondary outcomes. Fewer patients assigned to active treatment than to placebo had a stroke (relative risk, 0.75; 95 percent confidence interval, 0.59 to 0.97). More patients in the active-treatment group were hospitalized for unstable angina (relative risk, 1.24; 95 percent confidence interval, 1.04 to 1.49). Conclusions Supplements combining folic acid and vitamins B 6 and B 12 did not reduce the risk of major cardiovascular events in patients with vascular disease. (ClinicalTrials.gov number, NCT00106886; Current Controlled Trials number, ISRCTN14017017.)

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What should medical practitioners know about the role of alternative medicines in cardiovascular disease management

TL;DR: A wide range of alternative medications with relevance or connection to cardiovascular (CV) disease have been considered, and at least one, chelation therapy, is associated with definite harm, significant risk, no benefit, and enrichment of the practitioners who prescribe it.
Journal ArticleDOI

Relevance of plasma levels of free homocysteine and methionine as risk predictors for ischemic stroke in the young.

TL;DR: Significant but not-correlated, independent associations of fHcy and vitamin B6 with risk of premature, ischemic stroke are indicated, but the causality of these associations need prospective and large scale validations.
Journal ArticleDOI

Changes in lifestyle, biological risk factors and total homocysteine in relation to MTHFR C677T genotype: a 5-year follow-up study.

TL;DR: tHcy was not influenced by lifestyle changes except for the inverse association between beer consumption and tHcy observed in TT individuals, which suggests that tH Cy is not a mediator in the causal pathway between lifestyle and lifestyle-related diseases such as cardiovascular disease.
Journal ArticleDOI

A prospective cohort study of predictive value of homocysteine in patients with type 2 diabetes and coronary artery disease

TL;DR: In patients with type 2 diabetes and coronary artery disease, elevated level of homocysteine is an associate of increased cardiovascular risk but not an independent predictor of cardiovascular mortality.
Journal ArticleDOI

Primary Prevention and Health Services Delivery

TL;DR: The B vitamins reduce homocysteine serum levels raising the hope that treatment would be associated with reduced risk of stroke, but that hope was diminished with publication of results of the Vitamin Intervention for Stroke Prevention (VISP) trial in 2004.
References
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Journal ArticleDOI

Randomized Trial of Estrogen Plus Progestin for Secondary Prevention of Coronary Heart Disease in Postmenopausal Women

TL;DR: Treatment with oral conjugated equine estrogen plus medroxyprogesterone acetate did not reduce the overall rate of CHD events in postmenopausal women with established coronary disease and the treatment did increase the rate of thromboembolic events and gallbladder disease.
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Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction.

TL;DR: In this paper, the authors defined the definition of MI and established the following criteria for acute, evolving or recent MI: 1) Typical rise and gradual fall (troponin) or more rapid rise and fall (CK-MB) of biochemical markers of myocardial necrosis with at least one of the following: a) ischemic symptoms; b) development of pathologic Qwaves on the ECG; c) ECG changes indicative of ischemia (ST segment elevation or depression); or d) coronary artery intervention (e.g., coronary ang
Journal ArticleDOI

A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes

TL;DR: Higher folic acid intake by reducing tHcy levels promises to prevent arteriosclerotic vascular disease and under different assumptions, 13,500 to 50,000 CAD deaths annually could be avoided.
Journal ArticleDOI

Homocysteine and atherothrombosis

TL;DR: In 1969, McCully reported autopsy evidence of extensive arterial thrombosis and atherosclerosis in two children with elevated plasma homocyst(e)ine concentrations and homocysteine thiolactone, and it has recently become clear that hyperhomocyst (e)inemia is an independent risk factor.
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