Vitamins could help after heart attack

reference

Issa Om, Roberts R, Mark DB, et al. Effect of high -dose oral multivitamins and minerals in participants who were not treated with statins in the randomized study to evaluate chelatte therapy (tact). am heart j . 2018; 195: 70-77.

objective

evaluation of the difference in the results in a subgroup of participants (which do not revenue statins) who earn either a highly dosed oral multivitamin (OMV) or a placebo as part of the larger tact study.

draft

The Trial to Assess Chelat Therapy (TACT) was a clinical study to evaluate the results of chelate formation with ethyl diamintetra vinegar acid (EDTA) and an OMV for participants with a cardiac event in the history. A multifactorial 2-time 2-design was used to evaluate the active application and placebo for chelate formation and the OMV, consisting of 4 arms: 1) Active chelate formation and active omv; 2) active chelate formation and placebo ommv; 3) Placebo checks formation and active OMV; and 4) Placebo-Belat formation and placebo omv.

participant

The initial tact study included 1,708 patients aged 50 and over, who had suffered a heart attack at least 6 weeks before the recording. The patients were randomized for treatment; 839 patients with chelat and 869 patients with placebo. In the first study, 73 % of the participants took statins and 27 % (460) of the 1,708. The current publication only included those who do not take any statins during the study (n = 460). Almost half of them belonged to the group that received high -dose vitamins, while 51 % (n = 236) received placebo.

The average age of the tact participants was 65 years. The patient's heart attacks occurred on average 4.6 years before the admission. Of the participants, 18 % were women and 9 % minorities; The rest (73 %) were white men.

The original tact study population (n = 1708) had a high diabetes rate (31 %), former coronary revascularization (83 %) and taking medication such as aspirin (84 %), beta blockers (72 %), and statins (73 %).

medication and dosage study

The details of the vitamin formula used in the tact study are closer to formulas used by integrative and naturopathic doctors. The formula (from Xymogen) can be viewed under this link and compared to multivitamins that have been used in other major studies.

target parameter

The primary endpoint of tact was the time until the first appearance of a component of a composite endpoint: total mortality, myocardial infarction (Mi), stroke, coronary revascularization or hospital instruction due to angina pectoris. The most important secondary end point, a combination of cardiovascular death, myocardial infarction or not fatal stroke, was also calculated. The same endpoints were used in the analysis of this current study.

important knowledge

Primary endpoints occurred in 137 of these non-Statin study participants (30 %). Only 23 % (51 of 224) of those who took OMV achieved an end point event, compared to 36 % (86 of 236) of those in the placebo groups. These differences were statistically significant (Hazard Ratio [HR]: 0.62; 95% confidence interval [CI]: 0.44–0.87; p = 0.006).

In the secondary endpoint tact, the combination of cardiovascular mortality, stroke or recurrent myocardial infarction, the vitaming group still significantly better off (HR: 0.46; 95 % KI: 0.28–0.75; p = 0.002).

practice implications

Before we examine this new data, we have to refresh our memories of the first results of the tact study. In the first study, the patients received 40 treatments with intravenous EDTA-Schort formation or placebo infusions and either active OMV or placebo ommv, which results in a total of 4 arms for the study. The EDTA infusions were associated with a moderate reduction in some cardiac events about the 5-year follow-up time. Events occurred in 26 % of the Chelat group and 30 % of the placebo group, which corresponds to a 18 percent reduction in subsequent cardiac events in those who received Chelat. But it is not a striking difference. The primary endpoint appeared at 222 (26 %) of the Chelat group and 261 (30 %) of the placebo group (HR: 0.82; 95 %KI: 0.69-0.99; p = 0.035). There was no impact on the total mortality with 87 deaths (10 %) in the Chelat group and 93 deaths (11 %) in the placebo group (HR: 0.93; 95 %KI: 0.70-1.25; p = 0.64).

The EDTA-SCHELATION may have helped a little, but the benefits did not impress the researchers, especially when you consider how exhausting intravenous infusions.

This information can provide an argument for all MI patients take a similarly high-dose vitamin formula.

This current report is one of two reports that have examined sub-group populations within the tact study and report more significant effects.

This new report points out that taking multivitamins in non-statin users had a clinically significant effect. This information can provide an argument for all MI patients take a similarly high-dose vitamin formula. We have to consider that this advantage was only found in a subgroup analysis of patients who do not take any statins. The majority of the patients we encounter after a heart attack tends to adhere to your doctor's recommendations to a large extent and to take a statina medication.

also note that with participants who had stainless income, taking the vitamins brought no benefit. In fact, depending on the statistical methods used for the analysis, there were modest trends for somewhat better and somewhat worse results with an HR of 1.20 (95 % KI: 0.80–1.80; p = 0.385] according to the method of Anderson and Gill and an HR of 0.94 (95 % KI: 0.73-15; p = 0.542] According to the model of how, Lin and Weissfeld.

Here it starts to become interesting. A second earlier subgroup analysis of the tact data published in 2014 examined the results of diabetics in the first study. The authors report surprising results. The participants with diabetes who received chelate therapy had a significant reduction in events. During the 5-year study, patients with diabetes treated with EDTA had a risk of 25 % to achieve a primary endpoint, compared to 38 % in the non-Edta group (HR: 0.59; 95 % KI: 0.44–0.79; p <0.001).

The explanation now raised to explain the tact and diabetes results is that the metalchelation reduces the metal-catalyzed oxidation reactions that promote the formation of advanced glycation products (AGES). There is indications of a connection between the accumulation of toxic metals and diabetes-related cardiovascular diseases (CVD). ^{2 The chelate formation and targeted reduction of end products of the advanced glycation should now be viewed as a strategy to treat this subpopulation of patients.}

This is a fascinating idea. The formation of AGEs was recently described as the cause of the "metabolic memory in diabetics" and is considered a key factor in the formation of atherosclerotic plaques in patients with diabetes. ^{4 The AGEs disrupt the integrity of the vascular wall by damage the endothelial barrier and triggering the formation of foam cell lead. End products of advanced glycation also trigger an inflammatory reaction that leads to plaque formation. All of these processes lead to cardiovascular damage and finally to rupture and thrombosis. 4}

The measurement of Ages on the skin surface by simply counting "age spots" is significantly associated with internal measurements of cardiovascular diseases and heart function in patients with diabetes.

In order to understand whether the results of this current study are relevant to non-Statin users, you must understand the connection between diabetes and cardiovascular diseases of the AGE. We all know the main task of statins: the lowering of cholesterol levels. The ability of statins is less well known to ultimately prevent Ages from causing heart damage. Patients with diabetes are of course much more susceptible to Ages. Statins offer protection in patients without diabetes. For diabetics who do not take any statins, the high -dose vitamins and antioxidants offer a certain, albeit lower, measurable protection, simply because the ages are higher for diabetics.

The simple take-home measurement from these studies is that the advantages of statins may be due to their ability to reduce Ages. Diabetics may need the entire protection that AGEs can receive, and this may include chelate therapy. At least we should pay special attention to our diabetics with cardiovascular diseases and consider testing them, especially for heavy metal loads. Finally, patients who do not take a statin after a cardiac event should definitely consider a highly dose of multivitamin mineral formula, as used in the tact study.