Key result
Intravenous B-vitamins did not reduce perioperative myocardial injury compared to placebo (13.2% vs 13.6%; RR 1.02, 95% CI 0.78-1.32), nor did MTHFR gene variants increase risk.
Why the study?
Does intravenous B-vitamins prevent myocardial injury in adult patients with cardiac risk factors undergoing noncardiac surgery with nitrous oxide anesthesia?
RCT (n=500)
randomized
Does intravenous B-vitamins prevent myocardial injury in adult patients with cardiac risk factors undergoing noncardiac surgery with nitrous oxide anesthesia?
Relative Risk: 1.02 (95% CI 0.78–1.32)
Absolute Event Rate: 13.2% vs 13.6%
p-value: p=0.91
Intravenous B-vitamins blunt nitrous oxide-induced homocysteine increases but do not prevent perioperative myocardial injury in patients with cardiac risk factors undergoing noncardiac surgery.
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Does not support B-vitamin use to prevent perioperative myocardial injury; confirms null effect despite homocysteine reduction.
Nägele et al. (2013) conducted an RCT in cardiac risk factors undergoing noncardiac surgery (n=500). Intravenous B-vitamins vs. Placebo was evaluated on incidence of myocardial injury, as defined by cardiac troponin I increase within the first 72 h after surgery (RR 1.02, 95% CI 0.78-1.32, p=0.91). Intravenous B-vitamins did not reduce perioperative myocardial injury compared to placebo (13.2% vs 13.6%; RR 1.02, 95% CI 0.78-1.32), nor did MTHFR gene variants increase risk.
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