【文摘发布】降低高半胱氨酸水平不能降低静脉血栓栓塞的风险
这个帖子发布于 18 年零 30 天前，其中的信息可能已发生改变或有所发展。
Titil:Homocysteine-Lowering Therapy and Risk for Venous Thromboembolism
A Randomized Trial
Author:Joel G. Ray, MD, MSc; Clive Kearon, MD, PhD; Qilong Yi, PhD;et al
Resource:Annals of Internal Medicine, 5 June 2007 | Volume 146 Issue 11 | Pages 761-767
ABSTRACT
Background: Elevated total homocysteine levels are associated with a higher risk for venous thromboembolism. Whether decreasing homocysteine levels with vitamin therapy reduces the risk for venous thromboembolism is not known.
Objective: To determine whether decreasing homocysteine levels alters the risk for symptomatic venous thromboembolism.
Design: Secondary analysis of data from the randomized, placebo-controlled Heart Outcomes Prevention Evaluation 2 (HOPE-2) trial.
Setting: 145 clinical centers in 13 countries.
Participants: 5522 persons 55 years of age or older with known cardiovascular disease or diabetes mellitus and at least 1 other risk factor for vascular disease.
Intervention: A daily supplement of 2.5 mg of folic acid, 50 mg of vitamin B6, and 1 mg of vitamin B12 or matching placebo for 5 years.
Measurement: Prospectively diagnosed and confirmed symptomatic deep venous thrombosis or pulmonary embolism.
Results: The geometric mean homocysteine level decreased by 2.2 µmol/L in the vitamin therapy group and increased by 0.80 µmol/L in the placebo group. Venous thromboembolism occurred in 88 participants during a mean follow-up of 5 years. The incidence rate of venous thromboembolism was the same in the vitamin therapy group and the placebo group (0.35 per 100 person-years; hazard ratio, 1.01 [95% CI, 0.66 to 1.53]). Vitamin therapy did not reduce the risk for deep venous thrombosis (hazard ratio, 1.04 [CI, 0.63 to 1.72]), pulmonary embolism (hazard ratio, 1.14 [CI, 0.57 to 2.28]), or unprovoked venous thromboembolism (hazard ratio, 1.21 [CI, 0.66 to 2.23]).
Limitations: The proportion of patients with a previous episode of venous thromboembolism at enrollment was not known, and venous thromboembolism events were not centrally adjudicated.
Conclusion: Decreasing homocysteine levels with folic acid and vitamins B6 and B12 did not reduce the risk for symptomatic venous thromboembolism.
A Randomized Trial
Author:Joel G. Ray, MD, MSc; Clive Kearon, MD, PhD; Qilong Yi, PhD;et al
Resource:Annals of Internal Medicine, 5 June 2007 | Volume 146 Issue 11 | Pages 761-767
ABSTRACT
Background: Elevated total homocysteine levels are associated with a higher risk for venous thromboembolism. Whether decreasing homocysteine levels with vitamin therapy reduces the risk for venous thromboembolism is not known.
Objective: To determine whether decreasing homocysteine levels alters the risk for symptomatic venous thromboembolism.
Design: Secondary analysis of data from the randomized, placebo-controlled Heart Outcomes Prevention Evaluation 2 (HOPE-2) trial.
Setting: 145 clinical centers in 13 countries.
Participants: 5522 persons 55 years of age or older with known cardiovascular disease or diabetes mellitus and at least 1 other risk factor for vascular disease.
Intervention: A daily supplement of 2.5 mg of folic acid, 50 mg of vitamin B6, and 1 mg of vitamin B12 or matching placebo for 5 years.
Measurement: Prospectively diagnosed and confirmed symptomatic deep venous thrombosis or pulmonary embolism.
Results: The geometric mean homocysteine level decreased by 2.2 µmol/L in the vitamin therapy group and increased by 0.80 µmol/L in the placebo group. Venous thromboembolism occurred in 88 participants during a mean follow-up of 5 years. The incidence rate of venous thromboembolism was the same in the vitamin therapy group and the placebo group (0.35 per 100 person-years; hazard ratio, 1.01 [95% CI, 0.66 to 1.53]). Vitamin therapy did not reduce the risk for deep venous thrombosis (hazard ratio, 1.04 [CI, 0.63 to 1.72]), pulmonary embolism (hazard ratio, 1.14 [CI, 0.57 to 2.28]), or unprovoked venous thromboembolism (hazard ratio, 1.21 [CI, 0.66 to 2.23]).
Limitations: The proportion of patients with a previous episode of venous thromboembolism at enrollment was not known, and venous thromboembolism events were not centrally adjudicated.
Conclusion: Decreasing homocysteine levels with folic acid and vitamins B6 and B12 did not reduce the risk for symptomatic venous thromboembolism.
5 收藏点赞
