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Homocysteine-Lowering and Cardiovascular Disease Outcomes in Kidney Transplant RecipientsClinical Perspective
AG Bostom, MA Carpenter, JW Kusek, AS Levey... - Circulation, 2011 - Am Heart Assoc From the Rhode Island Hospital, Providence (AGB, JLM); Department of Biostatistics, the University
of North Carolina, Chapel Hill (MAC, LG-M.); National Institute of Diabetes and Digestive and
Kidney Diseases, Bethesda, MD (JWK); Tufts Medical Center, Boston, MA (ASL); ...
Methods and Results—In a double-blind controlled trial, we randomized 4110 stable kidney transplant recipients to a multivitamin that included either a high dose (n=2056) or low dose (n=2054) of folic acid, vitamin B6, and vitamin B12 to determine whether decreasing total homocysteine concentrations reduced the rate of the primary composite arteriosclerotic cardiovascular disease outcome (myocardial infarction, stroke, cardiovascular disease death, resuscitated sudden death, coronary artery or renal artery revascularization, lower-extremity arterial disease, carotid endarterectomy or angioplasty, or abdominal aortic aneurysm repair). Mean follow-up was 4.0 years. Treatment with the high-dose multivitamin reduced homocysteine but did not reduce the rates of the primary outcome (n=547 total events; hazards ratio [95 confidence interval]=0.99 [0.84 to 1.17]), secondary outcomes of all-cause mortality (n=431 deaths; 1.04 [0.86 to 1.26]), or dialysis-dependent kidney failure (n=343 events; 1.15 [0.93 to 1.43]) compared to the low-dose multivitamin.
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Homocysteine-Lowering and Cardiovascular Disease Outcomes in Kidney Transplant RecipientsClinical Perspective |
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