Antiplatelet therapy and the effects of B vitamins in patients with previous stroke or transient ischaemic attack: a post-hoc subanalysis of VITATOPS, a randomised, placebo-controlled trial.

Lancet Neurology
Graeme J HankeyVITATOPS Trial Study Group

Abstract

Previous studies have suggested that any benefits of folic acid-based therapy to lower serum homocysteine in prevention of cardiovascular events might be offset by concomitant use of antiplatelet therapy. We aimed to establish whether there is an interaction between antiplatelet therapy and the effects of folic acid-based homocysteine-lowering therapy on major vascular events in patients with stroke or transient ischaemic attack enrolled in the vitamins to prevent stroke (VITATOPS) trial. In the VITATOPS trial, 8164 patients with recent stroke or transient ischaemic attack were randomly allocated to double-blind treatment with one tablet daily of placebo or B vitamins (2 mg folic acid, 25 mg vitamin B(6), and 500 μg vitamin B(12)) and followed up for a median 3·4 years (IQR 2·0-5·5) for the primary composite outcome of stroke, myocardial infarction, or death from vascular causes. In our post-hoc analysis of the interaction between antiplatelet therapy and the effects of treatment with B vitamins on the primary outcome, we used Cox proportional hazards regression before and after adjusting for imbalances in baseline prognostic factors in participants who were and were not taking antiplatelet drugs at baseline and in participants...Continue Reading

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Citations

Jan 15, 2013·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Xianhui QinXiaobin Wang
Dec 24, 2013·Lancet Neurology·Graeme J Hankey
Aug 9, 2012·Translational Psychiatry·O P AlmeidaG J Hankey
May 5, 2012·Lancet Neurology·Gustavo Saposnik
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Apr 30, 2021·Herz·Hans Christoph Diener, Georg Nickenig

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Clinical Trials Mentioned

ISRCTN74743444
NCT00097669

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