effect of folic acid supplementation on cardiovascular outcomes a systematic review and meta-analysis叶酸对心血管的影响结果的系统回顾和荟萃分析.pdfVIP

Effect of Folic Acid Supplementation on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis 1. 2. 1. 1. 3 1 1 Yu-Hao Zhou , Jian-Yuan Tang , Mei-Jing Wu , Jian Lu , Xin Wei , Ying-Yi Qin , Chao Wang , 1 1 Jin-Fang Xu , Jia He * 1 Department of Health Statistics, Second Military Medical University, Shanghai, China, 2 Office of Compliance and Development, Center for Drug Evaluation, SFDA, Beijing, China, 3 Shanghai Jiao Tong University School of Medicine, Shanghai, China Abstract Background: Folic acid is widely used to lower homocysteine concentrations and prevent adverse cardiovascular outcomes. However, the effect of folic acid on cardiovascular events is not clear at the present time. We carried out a comprehensive systematic review and meta-analysis to assess the effects of folic acid supplementation on cardiovascular outcomes. Methodology and Principal Findings: We systematically searched Medline, EmBase, the Cochrane Central Register of Controlled Trials, reference lists of articles, and proceedings of major meetings for relevant literature. We included randomized placebo-controlled trials that reported on the effects of folic acid on cardiovascular events compared to placebo. Of 1594 identified studies, we included 16 trials reporting data on 44841 patients. These studies reported 8238 major cardiovascular events, 2001 strokes, 2917 myocardial infarctions, and 6314 deaths. Folic acid supplementation as compared to placebo had no effect on major cardiovascular events (RR, 0.98; 95% CI, 0.93–1.04), stroke (RR, 0.89; 95% CI,0.78–1.01), myocardial inf