Lowering homocysteine levels does not reduce rates of stroke, coronary heart disease or death in people with ischaemic stroke

Question. Do high doses of vitamins B6 and B12 and folic acid, which lower total homocysteine levels, reduce the risk of recurrent stroke, myocardial infarction or death compared with low doses in people with non disabling acute ischaemic stroke? Study design. Multicentre randomised controlled trial. Main results. High dose vitamins reduced mean total homocysteine levels by 2 μmol/l more than low dose vitamins. In people surviving a non disabling acute ischaemic stroke, no significant differences in rates of recurrent ischaemic stroke, coronary heart disease or death occurred between people receiving high dose or low dose vitamins over 2 years (see Table 1). A table is presented. Kaplan Meier estimates of events within 2 years. Analysis was performed with proportional hazards models adjusting for characteristics that differed significantly between treatment groups at baseline (see method notes). Authors' conclusions. In people with ischaemic stroke, lowering homocysteine levels does not reduce the rate of recurrent stroke, coronary heart disease or death.