Combined B-vitamin supplementation on homocysteine and vascular outcomes in coronary heart disease: a meta-analysis

source extracted confidence: high 2026-04-09
#humans #coronary-disease #vitamin-b-complex #dietary-supplements #homocysteine

Combined B-vitamin supplementation on homocysteine and vascular outcomes in coronary heart disease: a meta-analysis

Guo et al., 2026 | Ann Med | Meta Analysis

Citation

Guo Liping, Shi Xiangfen, ... Yuan Dongdong. Combined B-vitamin supplementation on homocysteine and vascular outcomes in coronary heart disease: a meta-analysis. Ann Med. 2026-Dec;58(1):2622208. doi:10.1080/07853890.2026.2622208

Abstract

OBJECTIVE: Hyperhomocysteinemia (Hcy) independently predicts coronary heart disease (CHD) and adverse cardiovascular events. Although folic acid plays a key role in Hcy metabolism, the effect of combined B-vitamin supplementation (folic acid, VB6, and VB12) on clinical outcomes in CHD remains uncertain. METHODS: A systematic search of PubMed, Embase, and the Cochrane Library was conducted from inception through April 2025 using MeSH terms including "folic acid," "vitamin B6," "vitamin B12," "coronary heart disease," and "homocysteine." A random-effects model was used for meta-analysis. RESULTS: Thirteen studies involving 14,539 participants were included in the meta-analysis (7,338 patients treated with folic acid combined with vitamin B complex and 7,301 controls). Combined B-vitamin supplementation significantly reduced serum Hcy levels [mean difference: -2.36; 95% confidence interval (CI): (-3.09 to -1.62); p < 0.01] compared with any single-nutrient regimen. The incidence of vascular restenosis was lower in the intervention group than in the control group (risk ratio: 0.65; 95% CI: 0.44-0.95; p < 0.05). However, no significant differences were observed in the incidence of major cardiovascular events (p = 0.78) or cardiovascular-related mortality (risk ratio: 0.96; 95% CI: 0.85-1.07; p = 0.44). CONCLUSION: Combined B-vitamin supplementation effectively lowers serum Hcy levels and the incidence of vascular restenosis in patients with CHD. However, its impact on cardiovascular events and mortality remains inconclusive.

Key Findings

Thirteen studies involving 14,539 participants were included in the meta-analysis (7,338 patients treated with folic acid combined with vitamin B complex and 7,301 controls). Combined B-vitamin supplementation significantly reduced serum Hcy levels [mean difference: -2.36; 95% confidence interval (CI): (-3.09 to -1.62); p < 0.01] compared with any single-nutrient regimen. The incidence of vascular restenosis was lower in the intervention group than in the control group (risk ratio: 0.65; 95% CI:

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population chd
Sample Size 14539
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Coronary Disease
  • Vitamin B Complex
  • Dietary Supplements
  • Homocysteine
  • Folic Acid
  • Vitamin B 6
  • Hyperhomocysteinemia
  • Vitamin B 12

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: folate

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09