Please use this identifier to cite or link to this item: https://doi.org/10.1161/STROKEAHA.111.641613
Title: Treatment with B vitamins and incidence of cancer in patients with previous stroke or transient ischemic attack: Results of a randomized placebo-controlled trial
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.
Schmidt, R.
Keywords: prevention
randomized controlled trials
Issue Date: Jun-2012
Citation: 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., Schmidt, R. (2012-06). 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) : 1572-1577. ScholarBank@NUS Repository. https://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. Clinical Trial Registration-: URL: www.clinicaltrials.gov. Unique identifier: NCT00097669. URL: www.controlled-trials.com. Unique identifier: ISRCTN74743444. © 2012 American Heart Association, Inc.
Source Title: Stroke
URI: http://scholarbank.nus.edu.sg/handle/10635/125656
ISSN: 00392499
DOI: 10.1161/STROKEAHA.111.641613
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