Format

Send to

Choose Destination
Am Heart J. 2018 Jan;195:70-77. doi: 10.1016/j.ahj.2017.09.002. Epub 2017 Sep 8.

Effect of high-dose oral multivitamins and minerals in participants not treated with statins in the randomized Trial to Assess Chelation Therapy (TACT).

Author information

1
Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, FL.
2
Duke University Clinical Research Institute, Durham, NC.
3
National Center of Complementary and Integrative Health (NCCIH), Bethesda, MD.
4
Palmer Center for Chiropractic Research, Davenport, IA.
5
National Heart, Blood and Lung Institute (NHLBI), Bethesda, MD.
6
Brigham and Women's Hospital, Boston, MA.
7
Pacific Pearl La Jolla, La Jolla, CA.
8
University of Kansas Medical Center, Kansas City, KS.
9
Magaziner Center for Wellness, Cherry Hill, NJ.
10
Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, FL. Electronic address: gervasio.lamas@msmc.com.

Abstract

IMPORTANCE:

In a prespecified subgroup analysis of participants not on statin therapy at baseline in the TACT, a high-dose complex oral multivitamins and multimineral regimen was found to have a large unexpected benefit compared with placebo. The regimen tested was substantially different from any vitamin regimen tested in prior clinical trials.

OBJECTIVE:

To explore these results, we performed detailed additional analyses of participants not on statins at enrollment in TACT.

DESIGN:

TACT was a factorial trial testing chelation treatments and a 28-component high-dose oral multivitamins and multiminerals regimen versus placebo in post-myocardial infarction (MI) patients 50 years or older.

PARTICIPANTS:

There were 460 (27%) of 1,708 TACT participants not taking statins at baseline, 224 (49%) were in the active vitamin group and 236 (51%) were in the placebo group.

SETTING:

Patients were enrolled at 134 sites around the United States and Canada.

INTERVENTION:

Daily high-dose oral multivitamins and multiminerals (6 tablets, active or placebo).

MAIN OUTCOME:

The primary end point of TACT was time to the first occurrence of any component of the composite end point: all-cause mortality, MI, stroke, coronary revascularization, or hospitalization for angina.

RESULTS:

The primary end point occurred in 137 nonstatin participants (30%), of which 51 (23%) of 224 were in the active group and 86 (36%) of 236 were taking placebo (hazard ratio, 0.62; 95% confidence interval, 0.44-0.87; P=.006). Results in the key TACT secondary end point, a combination of cardiovascular mortality, stroke, or recurrent MI, was consistent in favoring the active vitamin group (hazard ratio, 0.46; 95% confidence interval, 0.28-0.75; P=.002). Multiple end point analyses were consistent with these results.

CONCLUSION AND RELEVANCE:

High-dose oral multivitamin and multimineral supplementation seem to decrease combined cardiac events in a stable, post-MI population not taking statin therapy at baseline. These unexpected findings are being retested in the ongoing TACT2.

PMID:
29224648
DOI:
10.1016/j.ahj.2017.09.002
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center