High-dose multivitamins, multiminerals offer no cardioprotection in chronic coronary disease

For patients with chronic coronary disease, diabetes, and a previous myocardial infarction (MI), treatment with high-dose oral multivitamins and multiminerals (OMVM) alone or in conjunction with edetate disodium chelation therapy does not appear to reduce the incidence of major adverse cardiovascular events, as reported in a study.

The study included 1,000 patients (73 percent male) who were at least 50 years of age (median 67 years), had diabetes, and had an MI 6 weeks ago or more. These patients were randomly assigned to receive six caplets daily of a 28-component OMVM or matching OMVM placebo, in addition to 40 weekly infusions of an edetate disodium-based chelation solution or matching placebo (active OMVM plus active chelation, n=250; placebo OMVM plus active chelation, n=249; active OMVM plus placebo infusion, n=250; placebo OMVM plus placebo infusion, n=251).

Over a median follow-up of 48 months, the primary endpoint of the composite of all-cause mortality, MI, stroke, coronary revascularization, or hospitalization for unstable angina did not significantly differ between the combined active OMVM groups and the combined placebo OMVM groups (hazard ratio [HR], 0.99, 95 percent confidence interval [CI], 0.80-1.22]; P = .92).

The 5-year event rate for the primary endpoint was 34 percent with active OMVM plus active chelation, 35.7 percent with placebo OMVM plus active chelation, 36.0 percent with active OMVM plus placebo infusion, and 34.3 percent with placebo OMVM plus placebo infusion.

Compared with placebo OMVM plus placebo infusion, active OMVM plus active infusion was not associated with a significant reduction in the primary endpoint (HR, 0.91, 95 percent CI, 0.67–1.23; p=0.54). However, the number of MI, stroke, and cardiovascular disease-related mortality was numerically lower in the active OMVM group vs the placebo OMVM group.