Homocysteine-lowering interventions for preventing cardiovascular events.

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.

authors

Martí-Carvajal AJ,Solà I,Lathyris D

doi

10.1002/14651858.CD006612.pub4

subject

Has Abstract

pub_date

2015-01-15 00:00:00

pages

CD006612

issn

1469-493X

journal_volume

1

pub_type

杂志文章,meta分析,评审
  • Information provision for stroke patients and their caregivers.

    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

    authors: Forster A,Brown L,Smith J,House A,Knapp P,Wright JJ,Young J

    更新日期:2012-11-14 00:00:00

  • Bypass surgery for chronic lower limb ischaemia.

    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

    authors: Antoniou GA,Georgiadis GS,Antoniou SA,Makar RR,Smout JD,Torella F

    更新日期:2017-04-03 00:00:00

  • Bronchodilators delivered by nebuliser versus pMDI with spacer or DPI for exacerbations of COPD.

    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

    authors: van Geffen WH,Douma WR,Slebos DJ,Kerstjens HA

    更新日期:2016-08-29 00:00:00

  • Formulas containing hydrolysed protein for prevention of allergy and food intolerance in infants.

    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

    authors: Osborn DA,Sinn J

    更新日期:2006-10-18 00:00:00

  • Oestrogens and progestogens for preventing and treating postnatal depression.

    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

    authors: Lawrie TA,Herxheimer A,Dalton K

    更新日期:2000-01-01 00:00:00

  • Vaccines for preventing infection with Pseudomonas aeruginosa in people with cystic fibrosis.

    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

    authors: Keogan MT,Johansen HK

    更新日期:2000-01-01 00:00:00

  • Selenium for preventing cancer.

    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

    authors: Vinceti M,Dennert G,Crespi CM,Zwahlen M,Brinkman M,Zeegers MP,Horneber M,D'Amico R,Del Giovane C

    更新日期:2014-03-30 00:00:00

  • Treatment for amphetamine withdrawal.

    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

    authors: Srisurapanont M,Jarusuraisin N,Kittirattanapaiboon P

    更新日期:2001-01-01 00:00:00

  • Hypertonic versus near isotonic crystalloid for fluid resuscitation in critically ill patients.

    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

    authors: Bunn F,Roberts I,Tasker R,Akpa E

    更新日期:2004-01-01 00:00:00

  • Palivizumab for prophylaxis against respiratory syncytial virus infection in children with cystic fibrosis.

    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

    authors: Robinson KA,Odelola OA,Saldanha IJ

    更新日期:2016-07-20 00:00:00

  • Bisphosphonates in multiple myeloma.

    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

    authors: Mhaskar R,Redzepovic J,Wheatley K,Clark OA,Miladinovic B,Glasmacher A,Kumar A,Djulbegovic B

    更新日期:2010-03-17 00:00:00

  • Antibiotics for acute maxillary sinusitis in adults.

    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

    authors: Ahovuo-Saloranta A,Rautakorpi UM,Borisenko OV,Liira H,Williams JW Jr,Mäkelä M

    更新日期:2014-02-11 00:00:00

  • Botulinum toxin type A versus botulinum toxin type B for cervical dystonia.

    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

    authors: Costa J,Borges A,Espírito-Santo C,Ferreira J,Coelho M,Moore P,Sampaio C

    更新日期:2005-01-25 00:00:00

  • Perioperative ketamine for acute postoperative pain.

    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

    authors: Bell RF,Dahl JB,Moore RA,Kalso E

    更新日期:2006-01-25 00:00:00

  • Trifluoperazine versus low-potency first-generation antipsychotic drugs for schizophrenia.

    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

    authors: Tardy M,Dold M,Engel RR,Leucht S

    更新日期:2014-07-08 00:00:00

  • Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia.

    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:

    authors: Badawy SM,Morrone K,Thompson A,Palermo TM

    更新日期:2017-12-01 00:00:00

  • Omega 3 fatty acid for the prevention of cognitive decline and dementia.

    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

    authors: Sydenham E,Dangour AD,Lim WS

    更新日期:2012-06-13 00:00:00

  • Vitamin A and fish oils for retinitis pigmentosa.

    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

    authors: Rayapudi S,Schwartz SG,Wang X,Chavis P

    更新日期:2013-12-19 00:00:00

  • Conservative management of symptomatic and/or complicated haemorrhoids in pregnancy and the puerperium.

    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

    authors: Quijano CE,Abalos E

    更新日期:2005-07-20 00:00:00

  • Interventions for treating bisphosphonate-related osteonecrosis of the jaw (BRONJ).

    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

    authors: Rollason V,Laverrière A,MacDonald LC,Walsh T,Tramèr MR,Vogt-Ferrier NB

    更新日期:2016-02-26 00:00:00

  • Telephone counselling for smoking cessation.

    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

    authors: Stead LF,Lancaster T

    更新日期:2001-01-01 00:00:00

  • Interventions for improving modifiable risk factor control in the secondary prevention of stroke.

    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

    authors: Bridgwood B,Lager KE,Mistri AK,Khunti K,Wilson AD,Modi P

    更新日期:2018-05-07 00:00:00

  • Mediastinal chest drain clearance for cardiac surgery.

    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

    authors: Wallen M,Morrison A,Gillies D,O'Riordan E,Bridge C,Stoddart F

    更新日期:2004-10-18 00:00:00

  • Rapid antigen detection test for group A streptococcus in children with pharyngitis.

    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

    authors: Cohen JF,Bertille N,Cohen R,Chalumeau M

    更新日期:2016-07-04 00:00:00

  • Laparoscopic colposuspension for urinary incontinence in women.

    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

    authors: Freites J,Stewart F,Omar MI,Mashayekhi A,Agur WI

    更新日期:2019-12-10 00:00:00

  • Surfactant therapy for bronchiolitis in critically ill infants.

    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

    authors: Ventre K,Haroon M,Davison C

    更新日期:2006-07-19 00:00:00

  • Respiratory muscle training for cervical spinal cord injury.

    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

    authors: Berlowitz DJ,Tamplin J

    更新日期:2013-07-23 00:00:00

  • Intravenous in-line filters for preventing morbidity and mortality in neonates.

    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

    authors: Foster JP,Richards R,Showell MG,Jones LJ

    更新日期:2015-08-06 00:00:00

  • Circulating antigen tests and urine reagent strips for diagnosis of active schistosomiasis in endemic areas.

    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

    authors: Ochodo EA,Gopalakrishna G,Spek B,Reitsma JB,van Lieshout L,Polman K,Lamberton P,Bossuyt PM,Leeflang MM

    更新日期:2015-03-11 00:00:00

  • Risedronate for the prevention and treatment of postmenopausal osteoporosis.

    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

    authors: Cranney A,Waldegger L,Zytaruk N,Shea B,Weaver B,Papaioannou A,Robinson V,Wells G,Tugwell P,Adachi JD,Guyatt G

    更新日期:2003-01-01 00:00:00