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Table 1 Gradable clinical outcomes for dietary supplements plus cardiovascular drugs a

From: Interactions of commonly used dietary supplements with cardiovascular drugs: a systematic review

Item Supplement (dose) Cardiovascular drug Number of studies, sample size, characteristic (treatment duration) Outcome (combination versus control)
Clinical outcome efficacy     
All-cause mortality Coenzyme Q10 (100 mg/day) ACE inhibitors (80% of participants were also taking digoxin, furosemide, hydralazine and/or nitrates) Single study [53]; 30 mostly male patients with left ventricular dysfunction (3 months) Death: none versus one
  Ginkgo biloba (40 mg four times a day) Antiplatelet agents Single study [47]; 62 South Asian patients with previous ischemic stroke (1 month) No deaths
  Omega-3 fatty acids (4 g/day) Aspirin Single study [46]; 291 patients admitted for coronary artery bypass grafting (1 year) Death: five versus four
   Statins Single study [37]; 50 healthy nonsmoking adults (2 weeks) No deaths
   Warfarin Single study [46]; 319 patients admitted for coronary artery bypass grafting (1 year) Deaths: three versus two
   Fenofibrate Single study [55]; 167 participants with hyperglycemia (2 months) No deaths
Quality of life Coenzyme Q10 (100 mg/day) ACE inhibitors Single study [53]; 30 mostly male patients with left ventricular dysfunction (3 months) Minnesota ‘Living with Heart Failure’ questionnaire (mean sum of all scores post-treatment 26.7 ± 17.9 versus 26.5 ± 18.7
Myocardial infarction Omega-3 fatty acids (1.8 g eicosapentaenoic acid + 1.2 g docosahexaenoic acid) Aspirin + calcium channel antagonists Single study [50]; 58 patients who had undergone successful coronary angioplasty (6 months) Acute MI: 4 versus 2
     RR 1.70 (95% CI 0.32, 8.84)
Arrhythmia Omega-3 fatty acids (4 g/day) Statins Single study [41]; 256 patients with persistent hypertriglyceridemia despite statin therapy (2 months) Arrhythmia: one versus none
Stroke Vitamin E (0.4 g/day) Aspirin Single study [48]; 100 patients with previous reversible or irreversible ischemic neurologic deficit (2 years) Fatal or non-fatal stroke: three versus six
Ischemic stroke, hemorrhagic stroke and transient ischemic attack Vitamin E (600 IU/day) Aspirin Single study [40]; 19,934 healthy women (10 years) Composite outcome of nonfatal MI, nonfatal stroke and vascular death, RR 0.95 (95% CI 0.79, 1.13)
  1. aInconclusive results: studies had an imprecise statistically non-significant pooled estimate (the 95% CIs were wide enough to be compatible with either clinical benefit, true no difference or harm). ACE: angiotensin-converting enzyme; CI: confidence interval; MI: myocardial infarction; RR: relative risk.