Análisis crítico de un artículo: Vitaminas antioxidantes no reducen la mortalidad general ni cardiovascular

Introduction: Oxidized LDL is thought to play an important part in the pathogenesis of atherosclerosis. Observational studies have associated alpha tocopherol (vitamin E), beta carotene, or both, with reductions in cardiovascular events, but not clinical trials. We did a meta-analysis to assess the...

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Autores principales:	Capurro,Daniel, Caiozzi,Gianella
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2004
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000200017
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spelling	oai:scielo:S0034-988720040002000172005-11-23Análisis crítico de un artículo: Vitaminas antioxidantes no reducen la mortalidad general ni cardiovascularCapurro,DanielCaiozzi,GianellaIntroduction: Oxidized LDL is thought to play an important part in the pathogenesis of atherosclerosis. Observational studies have associated alpha tocopherol (vitamin E), beta carotene, or both, with reductions in cardiovascular events, but not clinical trials. We did a meta-analysis to assess the effect of these compounds on long term cardiovascular mortality and morbidity. Methods: We analyzed seven randomized trials of vitamin E treatment and, separately, eight of beta carotene treatment; all trials included 1000 or more patients. The dose range for vitamin E was 50-800 IU, and for beta carotene was 15-50 mg. Follow-up ranged from 1.4 to 12.0 years. Findings: The vitamin E trials involved a total of 81788 patients and the beta carotene trials 138113 in the all cause mortality analyses. Vitamin E did not provide benefit in mortality compared with control treatment (11.3 vs 11.1%, odds ratio 1.02 [95% CI 0.98-1.06] p=0.42) or significantly decrease risk of cardiovascular death (6.0 vs 6.0%, p=0.86) or cerebrovascular accident (3.6 vs 3.5%, p=0.31). Beta carotene led to a small but significant increase in all cause mortality (7.4 vs 7.0%, 1.07 [1.02-1.11] p=0.003) and with a slight increase in cardiovascular death (3.4 vs 3.1%, 1.1 [1.03-1.17] p=0.003). No significant heterogeneity was noted for any analysis. Interpretation: The lack of a salutary effect was seen consistently for various doses of vitamins in diverse populations. Our results, combined with the lack of mechanistic data for efficacy of vitamin E, do not support the routine use of vitamin Einfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.132 n.2 20042004-02-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000200017es10.4067/S0034-98872004000200017
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
description	Introduction: Oxidized LDL is thought to play an important part in the pathogenesis of atherosclerosis. Observational studies have associated alpha tocopherol (vitamin E), beta carotene, or both, with reductions in cardiovascular events, but not clinical trials. We did a meta-analysis to assess the effect of these compounds on long term cardiovascular mortality and morbidity. Methods: We analyzed seven randomized trials of vitamin E treatment and, separately, eight of beta carotene treatment; all trials included 1000 or more patients. The dose range for vitamin E was 50-800 IU, and for beta carotene was 15-50 mg. Follow-up ranged from 1.4 to 12.0 years. Findings: The vitamin E trials involved a total of 81788 patients and the beta carotene trials 138113 in the all cause mortality analyses. Vitamin E did not provide benefit in mortality compared with control treatment (11.3 vs 11.1%, odds ratio 1.02 [95% CI 0.98-1.06] p=0.42) or significantly decrease risk of cardiovascular death (6.0 vs 6.0%, p=0.86) or cerebrovascular accident (3.6 vs 3.5%, p=0.31). Beta carotene led to a small but significant increase in all cause mortality (7.4 vs 7.0%, 1.07 [1.02-1.11] p=0.003) and with a slight increase in cardiovascular death (3.4 vs 3.1%, 1.1 [1.03-1.17] p=0.003). No significant heterogeneity was noted for any analysis. Interpretation: The lack of a salutary effect was seen consistently for various doses of vitamins in diverse populations. Our results, combined with the lack of mechanistic data for efficacy of vitamin E, do not support the routine use of vitamin E
author	Capurro,Daniel Caiozzi,Gianella
spellingShingle	Capurro,Daniel Caiozzi,Gianella Análisis crítico de un artículo: Vitaminas antioxidantes no reducen la mortalidad general ni cardiovascular
author_facet	Capurro,Daniel Caiozzi,Gianella
author_sort	Capurro,Daniel
title	Análisis crítico de un artículo: Vitaminas antioxidantes no reducen la mortalidad general ni cardiovascular
title_short	Análisis crítico de un artículo: Vitaminas antioxidantes no reducen la mortalidad general ni cardiovascular
title_full	Análisis crítico de un artículo: Vitaminas antioxidantes no reducen la mortalidad general ni cardiovascular
title_fullStr	Análisis crítico de un artículo: Vitaminas antioxidantes no reducen la mortalidad general ni cardiovascular
title_full_unstemmed	Análisis crítico de un artículo: Vitaminas antioxidantes no reducen la mortalidad general ni cardiovascular
title_sort	análisis crítico de un artículo: vitaminas antioxidantes no reducen la mortalidad general ni cardiovascular
publisher	Sociedad Médica de Santiago
publishDate	2004
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000200017
work_keys_str_mv	AT capurrodaniel analisiscriticodeunarticulovitaminasantioxidantesnoreducenlamortalidadgeneralnicardiovascular AT caiozzigianella analisiscriticodeunarticulovitaminasantioxidantesnoreducenlamortalidadgeneralnicardiovascular
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Análisis crítico de un artículo: Vitaminas antioxidantes no reducen la mortalidad general ni cardiovascular

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