Effect of B vitamins and lowering homocysteine on cognitive impairment in patients with previous stroke or transient ischemic attack: a prespecified secondary analysis of a randomized, placebo-controlled trial and meta-analysis.
Abstract | BACKGROUND AND PURPOSE: METHODS: RESULTS: A total of 3089 participants (38%) voluntarily undertook the MMSE>6 months after the qualifying stroke; 2608 participants were cognitively unimpaired (MMSE≥24), of whom 2214 participants (1110 B-vitamins versus 1104 placebo) had follow-up MMSEs during 2.8 years (median). At final follow-up, allocation to B-vitamins, compared with placebo, was associated with a reduction in mean tHcy (10.2 μmol/L versus 14.2 μmol/L; P<0.001) but no change from baseline in the mean MMSE score (-0.22 points versus -0.25 points; difference, 0.03; 95% confidence interval, -0.13 to 0.19; P=0.726) and no difference in the incidence of cognitive impairment (5.51% versus 5.47%; risk ratio, 1.01; 95% confidence interval, 0.69-1.48; P=0.976), cognitive decline (9.1% versus 10.3%; risk ratio, 0.89; 0.67-1.18; P=0.414), or cognitive impairment or decline (11.0% versus 11.3%; risk ratio, 0.98; 0.75-1.27; P=0.855). CONCLUSIONS: CLINICAL TRIAL REGISTRATION: URL: http://www.controlled-trials.com. Unique identifier: ISRCTN74743444; URL: http://www.clinicaltrials.gov. Unique identifier: NCT00097669.
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Authors | Graeme J Hankey, Andrew H Ford, Qilong Yi, John W Eikelboom, Kennedy R Lees, Christopher Chen, Denis Xavier, Jose C Navarro, Udaya K Ranawaka, Wasim Uddin, Stefano Ricci, John Gommans, Reinhold Schmidt, Osvaldo P Almeida, Frank M van Bockxmeer, VITATOPS Trial Study Group |
Journal | Stroke
(Stroke)
Vol. 44
Issue 8
Pg. 2232-9
(Aug 2013)
ISSN: 1524-4628 [Electronic] United States |
PMID | 23765945
(Publication Type: Journal Article, Meta-Analysis, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Placebos
- Homocysteine
- Vitamin B Complex
- Vitamin B 12
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Topics |
- Aged
- Cognition Disorders
(drug therapy, etiology, prevention & control)
- Double-Blind Method
- Female
- Follow-Up Studies
- Homocysteine
(antagonists & inhibitors, blood)
- Humans
- Ischemic Attack, Transient
(complications, drug therapy)
- Male
- Middle Aged
- Placebos
- Recurrence
- Stroke
(complications, drug therapy)
- Treatment Outcome
- Vitamin B 12
(administration & dosage, physiology)
- Vitamin B Complex
(administration & dosage, pharmacology)
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