Treatment with B vitamins and incidence of cancer in patients with previous stroke or transient ischemic attack: results of a randomized placebo-controlled trial.

Hankey, G. J. et al. (2012) Treatment with B vitamins and incidence of cancer in patients with previous stroke or transient ischemic attack: results of a randomized placebo-controlled trial. Stroke, 43(6), pp. 1572-1577. (doi:10.1161/STROKEAHA.111.641613)

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Publisher's URL: http://dx.doi.org/10.1161/STROKEAHA.111.641613

Abstract

Background and Purpose—To determine the effect of B vitamin treatment on the incidence of cancer among patients with stroke or transient ischemic attack.

Methods—A total of 8164 patients with recent stroke or transient ischemic attack were randomly allocated to double-blind treatment with 1 tablet daily of placebo or B vitamins (2 mg folic acid, 25 mg vitamin B6, 500 μg vitamin B12) and followed for a median of 3.4 years for any cancer as an adverse event.

Results—There was no significant difference in the incidence of any cancer among participants assigned B vitamins compared with placebo (4.04% versus 4.59%; risk ratio, 0.86; 95% CI, 0.70–1.07) and no difference in cancer mortality (2.35% versus 2.09%; risk ratio, 1.09; 0.81–1.46). Among 1899 patients with diabetes, the incidence of cancer was higher among participants assigned B vitamins compared with placebo (5.35% versus 3.28%; adjusted risk ratio, 2.21; 1.31–3.73), whereas among 6168 patients without diabetes, the incidence of cancer was lower among participants assigned B vitamins compared with placebo (3.66% versus 5.03%; adjusted risk ratio, 0.67; 0.51–0.87; P for interaction=0.0001).

Conclusions—Daily administration of folic acid, vitamin B6, and vitamin B12 to 8164 patients with recent stroke or transient ischemic attack for a median of 3.4 years had no significant effect, compared with placebo, on cancer incidence or mortality. However, a post hoc subgroup analysis raises the hypothesis that folic acid treatment may increase the incidence of cancer among diabetics and reduce the incidence of cancer among nondiabetics with a history of stroke or transient ischemic attack.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lees, Professor Kennedy
Authors: Hankey, G. J., Eikelboom, J. W., Yi, Q., Lees, K. R., Chen, C., Xavier, D., Navarro, J. C., Ranawaka, U. K., Uddin, W., Ricci, S., Gommans, J., and Schmidt, R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Stroke
Publisher:American Heart Association
ISSN:0039-2499
ISSN (Online):1524-4628
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
345641VITATOPS study - a randomised, double-blind, placebo-controlled trial of vitamins to prevent strokeKennedy LeesMedical Research Council (MRC)G0200583RI CARDIOVASCULAR & MEDICAL SCIENCES
345642VITATOPS study - a randomised, double-blind, placebo-controlled trial of vitamins to prevent strokeKennedy LeesMedical Research Council (MRC)G0200583RI CARDIOVASCULAR & MEDICAL SCIENCES