Abstract
Globally, stroke is the fifth-most leading cause of mortality and also the third leading cause of disability. This study aimed to assess the effect of vitamin B6, B9, and B12 supplementation on homocysteine level, risk of stroke, cardiovascular disorders, and vascular death among stroke participants. An extensive literature search was done through PubMed, Medline, Embase, and Clinical key database from 1 January 2000 to 1 January 2020. Effect of vitamin B (B6, B9, and B12) supplementation on homocysteine was assessed with a mean difference in both vitamin and placebo groups. Risk ratio (RR) was calculated for determining the risk of stroke, major cardiovascular disorder, and vascular death by using a fixed-effect model. A total of eight trials with 8513 participants were included for the final analysis. Vitamin B supplementation intervention was found to have a significant benefit in reducing homocysteine in stroke patients (mean difference -3.84; p<0.00001). The intervention of vitamin B supplementation showed a significant risk reduction of 11% for combined risk of stroke, myocardial infarction, and vascular death among stroke patients, 13% for stroke and 17% for vascular death, whereas no beneficial effect was seen for cardiovascular disorders. This meta-analysis demonstrated up-to-date evidence on the beneficial effect of vitamin B supplementations in reducing homocysteine and preventing the combined risk of stroke, myocardial infarction, and vascular death among stroke patients.
Highlights
Stroke is the third-leading cause of disability among the elderly population
Five trials had the complete data for the primary endpoint of homocysteine, whereas two of them were selected for combined stroke, myocardial infarction, and vascular death; three of them had reported secondary endpoints for recurrence events of stroke; two of them for reporting cardiovascular events; and two trials for vascular death among both groups
This review showed a significant reduction of homocysteine levels among stroke participants
Summary
Stroke is the third-leading cause of disability among the elderly population. 70% of strokes were occurring in low-middle income countries" [1]. According to American Heart Association statistics, stroke ranked fifth for causing death in the US, causing 146,383 deaths in 2017. Statistics suggested 6.2 million deaths attributable to cerebrovascular disease worldwide, including 2.7 million deaths from ischemic stroke, 3 million deaths from an intracerebral hemorrhage, and 0.4 million deaths from subarachnoid hemorrhage. In 2016, on average, the rate of death by stroke was one every 3 minutes and 35 seconds. Several countries in Eastern Europe, Africa, and Central Asia have the highest mortality rates due to stroke [2]. Stroke is a leading cause of long-term disability. In 2018, stroke led to one in every six deaths from cardiovascular disease (CVD) [2]
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