Journal article

B vitamins in patients with recent transient ischaemic attack or stroke in the VITAmins TO Prevent Stroke (VITATOPS) trial: a randomised, double-blind, parallel, placebo-controlled trial

GJ Hankey, JW Eikelboom, RI Baker, A Gelavis, SC Hickling, K Jamrozik, FM van Bockxmeer, S Vasikaran, GJ Hankey, C Chen, JW Eikelboom, KR Lees, Q Yi, GJ Hankey, A Algra, C Chen, MC Wong, R Cheung, L Wong, I Divjak Show all

LANCET NEUROLOGY | ELSEVIER SCIENCE INC | Published : 2010

Abstract

BACKGROUND: Epidemiological studies suggest that raised plasma concentrations of total homocysteine might be a risk factor for major vascular events. Whether lowering total homocysteine with B vitamins prevents major vascular events in patients with previous stroke or transient ischaemic attack is unknown. We aimed to assess whether the addition of once-daily supplements of B vitamins to usual medical care would lower total homocysteine and reduce the combined incidence of non-fatal stroke, non-fatal myocardial infarction, and death attributable to vascular causes in patients with recent stroke or transient ischaemic attack of the brain or eye. METHODS: In this randomised, double-blind, para..

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Grants

Awarded by Australia National Health and Medical Research Council


Awarded by Australia National Heart Foundation


Awarded by Medical Research Council


Funding Acknowledgements

Australia National Health and Medical Research Council, UK Medical Research Council, Singapore Biomedical Research Council, Singapore National Medical Research Council, Australia National Heart Foundation, Royal Perth Hospital Medical Research Foundation, and Health Department of Western Australia.GJH has received payments for serving as a member of the executive committees of the ROCKET-AF (Johnson and Johnson), AMADEUS (Sanofi-Aventis), and BOREALIS (Sanofi-Aventis) trials; the steering committee of the TRA-2P TIMI 50 trial (Schering Plough); the Australian Pradaxa (dabigatran) advisory board (Boehringer Ingelheim); a working group on stroke and lipid management in Asia (Pfizer); has received honoraria for speaking at scientific symposia sponsored by Sanofi-Aventis and Pfizer Australia; and has received travel and accommodation expenses from Sanofi-Aventis. JWE has received consulting fees and honoraria for lecturing at sponsored scientific symposia from Bristol-Myers Squibb, Sanofi-Aventis, Eli Lilly, Astra, and Novartis, and has received payment for lectures from Bristol-Myers Squibb, Sanofi-Aventis, Eli Lilly, and Astra. JWE's institute has received grants from Bristol-Myers Squibb. CC has received payments for serving as national coordinator of the PERFORM (Servier) trial, on the data monitoring committee of the DU176B-C-J226 (Dai-Ichi) trial, as adviser to the ImpACT-24 (Brainsgate) trial, and for being part of a working group on stroke and lipid management in Asia (Pfizer), and has received travel and accommodation expenses from Moleac to attend the European Stroke Congress. KRL has received consultancy payments for serving on data monitoring committees for Lundbeck (DIAS-3,4), Boehringer Ingelheim (ECASS-3), Ferrer (ICTUS), Photothera (NEST-3), Archemix, Astellas, Mitsubishi, and Talecris, the trial endpoint committee for GlaxoSmithKline (RECORD), and the trial steering committees for D-Pharm (MACSI) and Servier (PERFORM) and has received honoraria for lectures at scientific symposia sponsored by Ferrer, Boehringer Ingelheim, and Sanofi-Aventis. QY has no conflicts of interest.The VITATOPS trial was funded by grants from the Australia National Health and Medical Research Council (project grants 110267, 403913, and 572632; program grants 251525 and 454417), the UK Medical Research Council, the Singapore Biomedical Research Council, the Singapore National Medical Research Council, the Australia National Heart Foundation, (grants G 99P 0405, G 02P 0735, G 04P 1611), the Royal Perth Hospital Medical Research Foundation, and the Health Department of Western Australia. The UK Stroke Research Network provided support for patient identification and enrolment in the UK. Infrastructure support was provided by Royal Perth Hospital, where the trial coordinating office was located and the Pharmacy Department stored and dispensed the tablets. Vitamin tablets and matching placebo tablets were supplied by Blackmores, Australia. Thanks to our trial coordinators Julia Pizzi and Michelle Tang, and to the 8164 patients in 20 countries who participated in the trial.