Cochrane · systematic review · CD006612
Homocysteine‐lowering interventions for preventing cardiovascular events
Martí-Carvajal, AJ, Solà, I, Lathyris, D, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
13
current version
GRADE rated
11
No studies
2
Included studies
NR
No studies 2 · 15.4%Ungraded 0 · 0%Very low 1 · 7.7%Low 0 · 0%Moderate 4 · 30.8%High 6 · 46.2%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Show all 4 versionsHomocysteine‐lowering interventions (Vitamin B6 (pyridoxine; pyridoxal); B9 (folic acid) or B12 (cyanocobalamin) compared with placebo or standard care for preventing cardiovascular events
Population: adults at risk of or with established cardiovascular disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Myocardial infarction Homocysteine‐lowering interventions (Vitamin B6 (pyridoxine; pyridoxal); B9 (folic acid) or B12 (cyanocobalamin) vs placebo or standard care | RR 1.02 [0.95, 1.1] | 12 studies · 46699 participants | High |
Stroke Homocysteine‐lowering interventions (Vitamin B6 (pyridoxine; pyridoxal); B9 (folic acid) or B12 (cyanocobalamin) vs placebo or standard care | RR 0.9 [0.82, 0.99] | 10 studies · 44224 participants | High |
Death by any cause Homocysteine‐lowering interventions (Vitamin B6 (pyridoxine; pyridoxal); B9 (folic acid) or B12 (cyanocobalamin) vs placebo or standard care | RR 1.01 [0.96, 1.06] | 11 studies · 44817 participants | High |
Adverse events Homocysteine‐lowering interventions (Vitamin B6 (pyridoxine; pyridoxal); B9 (folic acid) or B12 (cyanocobalamin) vs placebo or standard care | RR 1.07 [1, 1.14] | 8 studies · 35788 participants | High |
Homocysteine‐lowering interventions (high dose) compared with homocysteine‐lowering interventions (low dose) for preventing cardiovascular events
Population: adults at risk of or with established cardiovascular disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Myocardial infarction Homocysteine‐lowering interventions (high dose) vs homocysteine‐lowering interventions (low dose) | RR 0.9 [0.66, 1.23] | 1 study · 3649 participants | Moderate Downgraded: imprecision |
Stroke Homocysteine‐lowering interventions (high dose) vs homocysteine‐lowering interventions (low dose) | RR 0.9 [0.66, 1.22] | 2 studies · 3929 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Death by any cause Homocysteine‐lowering interventions (high dose) vs homocysteine‐lowering interventions (low dose) | RR 0.86 [0.66, 1.11] | 1 study · 3649 participants | Moderate Downgraded: imprecision |
Cancer Homocysteine‐lowering interventions (high dose) vs homocysteine‐lowering interventions (low dose) | no estimate extracted | NR | No studies |
Enalapril plus folic acid compared with enalapril for adults with hypertension
Population: adults with hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Myocardial infarction Enalapril plus folic acid vs enalapril | RR 1.04 [0.6, 1.82] | 1 study · 20702 participants | Moderate Downgraded: imprecision |
Stroke Enalapril plus folic acid vs enalapril | RR 0.79 [0.68, 0.93] | 1 study · 20702 participants | High |
First unstable angina pectoris episode requiring hospitalisation Enalapril plus folic acid vs enalapril | no estimate extracted | NR | No studies |
Death from any cause Enalapril plus folic acid vs enalapril | RR 0.94 [0.81, 1.1] | 1 study · 20702 participants | High |
Serious adverse event (cancer) Enalapril plus folic acid vs enalapril | RR 0.96 [0.71, 1.31] | 1 study · 20243 participants | Moderate Downgraded: imprecision |