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ASA: Good Adherence to Therapy May Benefit Stroke Patients

Homocysteine-lowering vitamin regimen also may benefit patients with known heart disease

THURSDAY, Feb. 19 (HealthDay News) -- In stroke patients, good adherence to recommended therapy could be associated with improved clinical outcomes. In patients with known cardiovascular disease, a homocysteine-lowering vitamin regimen also may be associated with better outcomes, according to research presented at the American Stroke Association's International Stroke Conference held Feb. 17 to 20 in San Diego.

In one study, Bruce Ovbiagele, M.D., of the University of California Los Angeles, and colleagues reviewed data from the Vitamin Intervention for Stroke Prevention trial in which 3,680 patients with recent stroke were randomly assigned to take either high-dose or low-dose homocysteine-lowering vitamins for two years. The researchers found that subjects with good adherence (more than 80 percent) were significantly less likely than those with poor adherence (80 percent or less) to experience another stroke, myocardial infarction or vascular death (13.4 percent versus 20.3 percent).

In a second study, Gustavo Saposnik, M.D., of the University of Toronto in Ontario, Canada, reviewed data from the Heart Outcomes Prevention Evaluation 2, in which 5,522 subjects with known cardiovascular disease were randomly assigned to a daily combination of 2.5 mg of folic acid, 50 mg of vitamin B6 and 1 mg of vitamin B12, or matching placebo, for five years. The investigators found that vitamin therapy was associated with a modestly reduced risk of stroke and non-fatal stroke (hazard ratios, 0.75 and 0.72, respectively).

"The benefit may be greater for individuals younger than 70 years and for those living in regions without folic acid food fortification," Saposnik and colleagues note.

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