TACT2
Trial question
What is the effect of multivitamins and multiminerals in patients with diabetes and prior MI?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
27.0% female
73.0% male
N = 1000
1000 patients (270 female, 730 male).
Inclusion criteria: patients aged ≥ 50 years with diabetes and prior MI.
Key exclusion criteria: serum creatinine > 2.0 mg/dL; HbA1c > 11%; MI within 6 weeks of randomization; coronary or peripheral arterial revascularization procedure performed within the last 6 months; planned revascularization procedure in the 6 months following enrolment; poor or no venous access in the upper extremities.
Interventions
N=500 multivitamins and multiminerals (oral multivitamins and multimineral 6 tablets daily).
N=500 placebo (oral matching placebo 6 tablets daily).
Primary outcome
Death, MI, stroke, coronary revascularization, or hospitalization for unstable angina
35%
35%
35.0 %
26.3 %
17.5 %
8.8 %
0.0 %
Multivitamins and
multiminerals
Placebo
No significant
difference ↔
No significant difference in death, MI, stroke, coronary revascularization, or hospitalization for unstable angina (35% vs. 35%; HR 0.99, 99% CI 0.8 to 1.22).
Secondary outcomes
No significant difference in MI, stroke, or CV death (21% vs. 16.2%; HR 1.3, 95% CI 0.97 to 1.73).
No significant difference in all-cause mortality (18% vs. 17%; HR 1.02, 95% CI 0.76 to 1.38).
Safety outcomes
No significant difference in serious adverse events.
Conclusion
In patients aged ≥ 50 years with diabetes and prior MI, multivitamins and multiminerals were not superior to placebo with respect to death, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina.
Reference
Francisco Ujueta, Gervasio A Lamas, Kevin J Anstrom et al. Multivitamins After Myocardial Infarction in Patients With Diabetes: A Randomized Clinical Trial. JAMA Intern Med. 2025 May 1;185(5):540-548.
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