The effect of folic acid in patients with cardiovascular disease: A systematic review and meta-analysis - PubMed (original) (raw)
Meta-Analysis
The effect of folic acid in patients with cardiovascular disease: A systematic review and meta-analysis
Yuan Wang et al. Medicine (Baltimore). 2019 Sep.
Abstract
Background: The effectiveness of folic acid supplementation in stroke risk has been investigated, however, the available results are inconclusive and conflicting. The purpose of this systemic review and meta-analysis was to assess the effect of folic acid in patients with cardiovascular disease (CVD).
Methods: By searching the PubMed, EMBASE, and Cochrane library databases, we conducted a meta-analysis to evaluate effect of folic acid supplementation in patients with CVD. All-cause mortality, cardiovascular mortality, the risk of coronary heart disease (CHD) and stroke were summarized; hazard ratios (HR), the relative risk (RR) and its 95% confidence interval (CI) were also calculated. Fixed effects models were used to combine the data. A total of 12 randomized controlled trials, which involved 47,523 participants, met the inclusion criteria in this systematic review and meta-analysis.
Results: Our meta-analysis showed that cardiovascular patients who received folic acid therapy had significantly decreased risk of stroke (RR = 0.85, 95% CI = 0.77-0.94, Pheterogeneity = .347, I = 10.6%) compared with patients who received control treatment. However, no significant difference in all-cause mortality (HR, 0.97, 95% CI, 0.86-1.10, Pheterogeneity = .315, I = 15.4%), cardiovascular mortality (HR, 0.87, 95% CI, 0.66-1.15, Pheterogeneity = .567, I = 0) and risk of CHD (RR, 1.04, 95% CI, 0.99-1.10, Pheterogeneity = .725, I = 0) were found between the 2 groups.
Conclusion: This meta-analysis suggested that folic acid supplementation significantly reduced the risk of stroke in patients with CVD.
Conflict of interest statement
The authors have no conflicts of interests to disclose.
Figures
Figure 1
Flow diagram of studies identification.
Figure 2
Risk of bias assessments for the randomized trials included in the meta-analysis. (A) Risk of bias summary; (B) Risk of bias graph. Symbols. (+): low risk of bias; (?): unclear risk of bias; (-): high risk of bias.
Figure 3
The effect of folic acid in patients with cardiovascular disease. (A) All-cause mortality; (B) Cardiovascular mortality; (C) Coronary heart disease; (D) Stroke.
Figure 4
Sensitivity analysis of the effect of folic acid in patients with with cardiovascular disease. (A) All-cause mortality; (B) Cardiovascular mortality; (C) Coronary heart disease; (D) Stroke.
Figure 5
Funnel plot for publication bias test. Each point represents a separate study for the indicated association. (A) All-cause mortality; (B) Cardiovascular mortality; (C) Coronary heart disease; (D) Stroke.
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