Abstract:
BACKGROUND:Cardiovascular disease, which includes coronary artery disease, stroke and congestive heart failure, is a leading cause of death worldwide. Homocysteine is an amino acid with biological functions in methionine metabolism. A postulated risk factor is an elevated circulating total homocysteine level, which is associated with cardiovascular events. The impact of homocysteine-lowering interventions, given to patients in the form of vitamins B6, B9 or B12 supplements, on cardiovascular events. This is an update of a review previously published in 2009 and 2013. OBJECTIVES:To determine whether homocysteine-lowering interventions, provided in patients with and without pre-existing cardiovascular disease are effective in preventing cardiovascular events, as well as all-cause mortality and evaluate their safety. SEARCH METHODS:We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2014, Issue 1), MEDLINE (1950 to January week 5 2014), EMBASE (1980 to 2014 week 6) and LILACS (1986 to February 2014). We also searched Web of Science (1970 to 7 February 2014). We handsearched the reference lists of included papers. We also contacted researchers in the field. There was no language restriction in the search. SELECTION CRITERIA:We included randomised controlled trials assessing the effects of homocysteine-lowering interventions for preventing cardiovascular events with a follow-up period of one year or longer. We considered myocardial infarction and stroke as the primary outcomes. We excluded studies in patients with end-stage renal disease. DATA COLLECTION AND ANALYSIS:We performed study selection, 'Risk of bias' assessment and data extraction in duplicate. We estimated risk ratios (RR) for dichotomous outcomes. We measured statistical heterogeneity using the I(2) statistic. We used a random-effects model. MAIN RESULTS:In this second updated Cochrane Review, we identified no new randomised controlled trials. Therefore, this new version includes 12 randomised controlled trials involving 47,429 participants. In general terms, 75% (9/12) trials had a low risk of bias. Homocysteine-lowering interventions compared with placebo did not significantly affect non-fatal or fatal myocardial infarction (1743/23,590 (7.38%) versus 1247/20,190 (6.17%); RR 1.02, 95% confidence interval (CI) 0.95 to 1.10, I(2) = 0%, high quality evidence), stroke (968/22,348 (4.33%) versus 974/18,957 (5.13%); RR 0.91, 95% CI 0.82 to 1.0, I(2) = 11%, high quality evidence) or death from any cause (2784/22,648 (12.29%) versus 2502/19,250 (10.64%); RR 1.01, 95% CI 0.96 to 1.07, I(2) = 6%, high quality evidence). Homocysteine-lowering interventions compared with placebo did not significantly affect serious adverse events (cancer) (1558/18,130 (8.59%) versus 1334/14,739 (9.05%); RR 1.06, 95% CI 0.98 to 1.13; I(2) = 0%, high quality evidence). AUTHORS' CONCLUSIONS:This second update of this Cochrane Review found no evidence to suggest that homocysteine-lowering interventions in the form of supplements of vitamins B6, B9 or B12 given alone or in combination should be used for preventing cardiovascular events. Furthermore, there is no evidence to suggest that homocysteine-lowering interventions are associated with an increased risk of cancer.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Martí-Carvajal AJ,Solà I,Lathyris Ddoi
10.1002/14651858.CD006612.pub4subject
Has Abstractpub_date
2015-01-15 00:00:00pages
CD006612issn
1469-493Xjournal_volume
1pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Research shows that stroke patients and their families are dissatisfied with the information provided and have a poor understanding of stroke and associated issues. OBJECTIVES:To assess the effectiveness of information provision strategies in improving the outcome for stroke patients or their identified car...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001919.pub3
更新日期:2012-11-14 00:00:00
abstract:BACKGROUND:Bypass surgery is one of the mainstay treatments for patients with critical lower limb ischaemia (CLI). This is the second update of the review first published in 2000. OBJECTIVES:To assess the effects of bypass surgery in patients with chronic lower limb ischaemia. SEARCH METHODS:For this update, the Coch...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD002000.pub3
更新日期:2017-04-03 00:00:00
abstract:BACKGROUND:Bronchodilators are a central component for treating exacerbations of chronic obstructive pulmonary disease (COPD) all over the world. Clinicians often use nebulisers as a mode of delivery, especially in the acute setting, and many patients seem to benefit from them. However, evidence supporting this choice ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD011826.pub2
更新日期:2016-08-29 00:00:00
abstract:BACKGROUND:Allergies and food reactions are common and may be associated with foods including adapted cow's milk formula. Formulas containing hydrolysed proteins have been used to treat infants with allergy or food intolerance. However, it is unclear whether hydrolysed formula can be advocated for prevention of allergy...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD003664.pub3
更新日期:2006-10-18 00:00:00
abstract:BACKGROUND:Postnatal depression, with a prevalence of at least 10%, is probably the most common complication of the puerperium. A deficiency or imbalance of sex hormones has repeatedly been suggested as a cause. OBJECTIVES:The objective of this review was to evaluate the role of oestrogens and progestogens in the prev...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001690
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:To assess the effectiveness of vaccination against Pseudomonas aeruginosa in patients with cystic fibrosis. SEARCH STRATEGY:The Cochrane Cystic Fibrosis and Genetic Disorders Group specialist trials register which comprises references identified from comprehensive electronic database searches, handsearching...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001399
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:This review is an update of the first Cochrane publication on selenium for preventing cancer (Dennert 2011).Selenium is a metalloid with both nutritional and toxicological properties. Higher selenium exposure and selenium supplements have been suggested to protect against several types of cancers. OBJECTIVE...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005195.pub3
更新日期:2014-03-30 00:00:00
abstract:BACKGROUND:Amphetamine withdrawal has been less studied although it is a common problem with a prevalent rate of 87% among amphetamine users. Its symptoms, in particular intense craving, may be a critical factor leading to relapse of amphetamine use. In clinical practice, treatment for cocaine withdrawal has been recom...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003021
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Hypertonic solutions are considered to have a greater ability to expand blood volume and thus elevate blood pressure and can be administered as a small volume infusion over a short time period. On the other hand, the use of hypertonic solutions for volume replacement may also have important disadvantages. O...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD002045.pub2
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Respiratory syncytial virus infection causes acute lung infection in infants and young children worldwide, resulting in considerable morbidity and mortality. Children with cystic fibrosis are prone to recurrent lung inflammation, bacterial colonisation and subsequent chronic airway disease, putting them at r...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD007743.pub6
更新日期:2016-07-20 00:00:00
abstract:BACKGROUND:Bisphosphonates are specific inhibitors of osteoclastic activity and are currently used as supportive therapy for multiple myeloma (MM). However, the exact clinical role of bisphosphonates in MM remains unclear. OBJECTIVES:This update of the first review published in 2002. We have also analyzed observationa...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003188.pub2
更新日期:2010-03-17 00:00:00
abstract:BACKGROUND:Sinusitis is one of the most common diagnoses among adults in ambulatory care, accounting for 15% to 21% of all adult outpatient antibiotic prescriptions. However, the role of antibiotics for sinusitis is controversial. OBJECTIVES:To assess the effects of antibiotics in adults with acute maxillary sinusitis...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD000243.pub3
更新日期:2014-02-11 00:00:00
abstract:BACKGROUND:Cervical dystonia is the most common form of focal dystonia. It is characterized by involuntary posturing of the head and frequently is associated with neck pain. Disability and social withdrawal are common. Most cases are idiopathic, and generally it is a life-long disorder. In recent years, botulinum toxin...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD004314.pub2
更新日期:2005-01-25 00:00:00
abstract:BACKGROUND:Postoperative pain management is often limited by adverse effects such as nausea and vomiting. Adjuvant treatment with an inexpensive opioid-sparing drug such as ketamine may be of value in giving better analgesia with fewer adverse effects. OBJECTIVES:To evaluate the effectiveness and tolerability of ketam...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004603.pub2
更新日期:2006-01-25 00:00:00
abstract:BACKGROUND:Antipsychotic drugs are the core treatment for schizophrenia. Treatment guidelines state that there is no difference in efficacy between any other antipsychotic compounds, however, low-potency antipsychotic drugs are often perceived as less efficacious than high-potency compounds by clinicians, and they also...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009396.pub2
更新日期:2014-07-08 00:00:00
abstract::This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To identify and assess the effects of computer and mobile technology interventions designed to facilitate medication adherence and disease management in individuals with thalassemia, including: evaluating the effects of using compu...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章
doi:
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Evidence from observational studies suggests that diets high in omega-3 long-chain polyunsaturated fatty acids (PUFA) may protect people from cognitive decline and dementia. The strength of this potential protective effect has recently been tested in randomised controlled trials. OBJECTIVES:To assess the ef...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005379.pub3
更新日期:2012-06-13 00:00:00
abstract:BACKGROUND:Retinitis pigmentosa (RP) comprises a group of hereditary eye diseases characterized by progressive degeneration of retinal photoreceptors. It results in severe visual loss that may lead to legal blindness. Symptoms may become manifest during childhood or adulthood, and include poor night vision (nyctalopia)...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD008428.pub2
更新日期:2013-12-19 00:00:00
abstract:BACKGROUND:Haemorrhoids (piles) are swollen veins at or near the anus, normally asymptomatic. They do not constitute a disease, unless they become symptomatic. Pregnancy and the puerperium predispose to symptomatic haemorrhoids, being the most common ano-rectal disease at these stages. Symptoms are usually mild and tra...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD004077.pub2
更新日期:2005-07-20 00:00:00
abstract:BACKGROUND:Bisphosphonate drugs can be used to prevent and treat osteoporosis and to reduce symptoms and complications of metastatic bone disease; however, they are associated with a rare but serious adverse event: osteonecrosis of the maxillary and mandibular bones. This condition is called bisphosphonate-related oste...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD008455.pub2
更新日期:2016-02-26 00:00:00
abstract:BACKGROUND:Telephone services can provide information and support for smokers. Counselling may be provided proactively or offered reactively to callers to smoking cessation helplines. OBJECTIVES:To evaluate the effect of proactive and reactive telephone support to help smokers quit. SEARCH STRATEGY:We searched the Co...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002850
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:People with stroke or transient ischaemic attack (TIA) are at increased risk of future stroke and other cardiovascular events. Stroke services need to be configured to maximise the adoption of evidence-based strategies for secondary stroke prevention. Smoking-related interventions were examined in a separate...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009103.pub3
更新日期:2018-05-07 00:00:00
abstract:BACKGROUND:Cardiac tamponade may occur following cardiac surgery as a result of blood or fluid collecting in the pericardial space compressing the heart and reducing cardiac output. Mediastinal chest drains (including pericardial drains) are inserted as standard post-operative practice following cardiac surgery to assi...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003042.pub2
更新日期:2004-10-18 00:00:00
abstract:BACKGROUND:Group A streptococcus (GAS) accounts for 20% to 40% of cases of pharyngitis in children; the remaining cases are caused by viruses. Compared with throat culture, rapid antigen detection tests (RADTs) offer diagnosis at the point of care (within five to 10 minutes). OBJECTIVES:To determine the diagnostic acc...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD010502.pub2
更新日期:2016-07-04 00:00:00
abstract:BACKGROUND:Laparoscopic colposuspension was one of the first minimal access operations for treating stress urinary incontinence in women, with the presumed advantages of shorter hospital stays and quicker return to normal activities. This Cochrane Review was last updated in 2010. OBJECTIVES:To assess the effects of la...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD002239.pub4
更新日期:2019-12-10 00:00:00
abstract:BACKGROUND:Viral bronchiolitis is a common cause of respiratory failure in infants and children, and accounts for a significant portion of intensive care unit (ICU) admissions during seasonal epidemics. Currently there is no evidence to support the use of anything but supportive care for this disease. Surfactant is a p...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005150.pub2
更新日期:2006-07-19 00:00:00
abstract:BACKGROUND:Cervical spinal cord injury (SCI) severely comprises respiratory function due to paralysis and impairment of the respiratory muscles. Various types of respiratory muscle training (RMT) to improve respiratory function for people with cervical SCI have been described in the literature. A systematic review of t...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008507.pub2
更新日期:2013-07-23 00:00:00
abstract:BACKGROUND:Venous access is an essential part of caring for the sick neonate. However, problems such as contamination of fluids with bacteria, endotoxins and particulates have been associated with intravenous infusion therapy. Intravenous in-line filters claim to be an effective strategy for the removal of bacteria, en...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005248.pub3
更新日期:2015-08-06 00:00:00
abstract:BACKGROUND:Point-of-care (POC) tests for diagnosing schistosomiasis include tests based on circulating antigen detection and urine reagent strip tests. If they had sufficient diagnostic accuracy they could replace conventional microscopy as they provide a quicker answer and are easier to use. OBJECTIVES:To summarise t...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009579.pub2
更新日期:2015-03-11 00:00:00
abstract:BACKGROUND:Postmenopausal osteoporosis results in an increased susceptibility to low-trauma fractures due to reduced bone volume and microarchitectural deterioration. Risedronate, a third generation bisphosphonate, has been shown in multiple clinical trials to reduce fracture risk and improve bone mineral density in po...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD004523
更新日期:2003-01-01 00:00:00