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High-Dose Multivitamins and Minerals After a Heart Attack FREE

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The full report is titled “Oral High-Dose Multivitamins and Minerals After Myocardial Infarction. A Randomized Trial.” It is in the 17 December 2013 issue of Annals of Internal Medicine (volume 159, pages 797-804). The authors are G.A. Lamas, R. Boineau, C. Goertz, D.B. Mark, Y. Rosenberg, M. Stylianou, T. Rozema, R.L. Nahin, L. Lindblad, E.F. Lewis, J. Drisko, and K.L. Lee, for the TACT Investigators.

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Ann Intern Med. 2013;159(12):I-20. doi:10.7326/0003-4819-159-12-201312170-00001
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What is the problem and what is known about it so far?

People who have had a heart attack are at high risk for additional heart attacks; other cardiovascular events, such as stroke; and death. Multivitamins and minerals are thought to have antioxidant and other effects that might be useful in patients with heart disease. However, whether vitamins and minerals can prevent additional heart attacks, stroke, death, or other cardiovascular events in people who have already had a heart attack is unknown.

Why did the researchers do this particular study?

To find out whether high doses of multivitamins and minerals can prevent heart attacks, strokes, death, and other cardiovascular events in people who have already had a heart attack.

Who was studied?

1708 people who have had a heart attack.

How was the study done?

The researchers enrolled patients who had had a heart attack at least 6 weeks before, then randomly assigned them to receive daily pills containing high-dose multivitamins and minerals or daily placebo pills. The patients were to receive the pills for up to 5 years. They were followed by study personnel to find out whether they had another heart attack, had chest pain requiring hospitalization, needed a cardiac catheterization, had a stroke, or died. The patients, study personnel, and physicians caring for the patients did not know whether the patients were receiving placebo or multivitamin and mineral pills.

What did the researchers find?

After a median follow-up of 55 months, the occurrence of another heart attack, chest pain requiring hospitalization, the need for cardiac catheterization, stroke, or death did not significantly differ between the groups. The group receiving the high-dose multivitamins and minerals did not seem to have more adverse effects than that taking placebo pills.

What were the limitations of the study?

Many people in both groups stopped taking the pills, did not take the pills as often as they were instructed, or stopped participating in the study before it was planned to end. Therefore, it is harder to draw firm conclusions about what high-dose multivitamins and minerals may do.

What are the implications of the study?

Although high-dose multivitamins and minerals did not seem to be harmful, they did not seem to reduce heart attacks, stroke, or death after a previous heart attack.





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