Archief Roodbont

Despite the theoretical benefits of lowering homocysteine levels through vitamin B supplementation, randomized trials have failed to show that vitamin B therapy prevents cardiovascular events. In addition, trials of -3 fatty acid supplementation have yielded conflicting results. This double-blind placebo-controlled French trial involved 2501 patients with myocardial infarction (MI), unstable angina, or stroke within the past 12 months. Patients were randomized to receive B vitamins, -3 fatty acids, both, or neither. The B vitamins were 5-methyltetrahydrofolate (560 µg), B₆ (3 mg), and B₁₂ (20 µg), and the -3 fatty acids were eicosapentaenoic acid and docosahexaenoic acid at a ratio of 2:1 (600 mg).

During median follow-up of 4.7 years, vitamin B therapy had no effect on a composite outcome of major adverse cardiovascular events and had no effect on MI, all adverse coronary events, cerebrovascular events, and revascularizations; vitamin B supplementation was associated with lower stroke risk but higher overall mortality. -3 fatty acid supplementation had no effect on major CV events together or individually.

Comment: The results of this trial and others (including a recent -3 fatty acid study; JW Cardiol Aug 30 2010) indicate that dietary supplementation with B vitamins and -3 fatty acids does not prevent major CV events in patients with previous adverse coronary events or stroke.

— Paul S. Mueller, MD, MPH, FACP

Published in Journal Watch General Medicine January 18, 2011