|
Recommendation for
Homocysteine Lowering |
|
COR |
LOE |
Recommendation |
|
III: No Benefit |
B-R |
B-complex vitamin supplementation
to lower homocysteine levels for prevention of cardiovascular
events in patients with PAD is not recommended.205–207
|
|
See Online Data Supplements 28 and
29. |
Although patients with PAD have been
shown to have increased plasma homocysteine levels compared with
patients without PAD, there is no evidence that B-complex vitamin
supplementation improves clinical outcomes in patients with
PAD.207
The HOPE-2 trial randomized 5522 patients with atherosclerotic
vascular disease, including symptomatic PAD, or diabetes mellitus
with additional risk factors to receive folic acid/vitamin
B6/vitamin B12 or placebo.205,206 Despite lowering of homocysteine levels in the
vitamin supplementation arm, there was no improvement in the primary
endpoint of cardiovascular death, MI, or stroke. |
|