Stroke: B vitamins show benefit in absence of antiplatelet therapy

摘要

In 2010, the vitamins to prevent stroke (VITATOPS) trial found no beneficial effect of daily B vitamin supplementation for the secondary prevention of major vascular events. However, a recent post-hoc analysis of data from this trial has revealed a beneficial effect of B vitamins in patients who were not receiving antiplatelet therapy.Homocysteine is an endogenous amino acid present in plasma, and breakdown of this molecule requires the presence of B vitamins, such as folic acid. High levels of homocysteine in the serum has been associated with an increased risk of many neurological and vascular disorders, such as Alzheimer disease and stroke.The VITATOPS trial, involving 8,164 patients with recent stroke or transient ischaemic attack, found no effect of daily B vitamin supplementation over placebo for preventing secondary major vascular events.