title: The effect of multiple micronutrient supplementation on left ventricular ejection fraction in patients with chronic stable heart failure: a randomized, placebo-controlled trial.
abstract: OBJECTIVE
  This study sought to investigate the effect of a multiple micronutrient supplement on left ventricular ejection fraction (LVEF) in patients with heart failure.
  
  
  BACKGROUND
  Observational studies suggest that patients with heart failure have reduced intake and lower concentrations of a number of micronutrients. However, there have been very few intervention studies investigating the effect of micronutrient supplementation in patients with heart failure.
  
  
  METHODS
  This was a randomized, double-blind, placebo-controlled, parallel-group study involving 74 patients with chronic stable heart failure that compared multiple micronutrient supplementation taken once daily versus placebo for 12 months. The primary endpoint was LVEF assessed by cardiovascular magnetic resonance imaging or 3-dimensional echocardiography. Secondary endpoints were Minnesota Living With Heart Failure Questionnaire score, 6-min walk test distance, blood concentrations of N-terminal prohormone of brain natriuretic peptide, C-reactive protein, tumor necrosis factor alpha, interleukin-6, interleukin-10, and urinary levels of 8-iso-prostaglandin F2 alpha.
  
  
  RESULTS
  Blood concentrations of a number of micronutrients increased significantly in the micronutrient supplement group, indicating excellent compliance with the intervention. There was no significant difference in mean LVEF at 12 months between treatment groups after adjusting for baseline (mean difference: 1.6%, 95% confidence interval: -2.6 to 5.8, p = 0.441). There was also no significant difference in any of the secondary endpoints at 12 months between treatment groups.
  
  
  CONCLUSIONS
  This study provides no evidence to support the routine treatment of patients with chronic stable heart failure with a multiple micronutrient supplement. (Micronutrient Supplementation in Patients With Heart Failure [MINT-HF]; NCT01005303).
authors: Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland; The Heart Centre, Belfast Health & Social Care Trust, Belfast, Northern Ireland. Electronic address: nickmckeag@googlemail.com.
authors: Nicholas A
authors: NA
authors: McKeag
authors: Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.
authors: Michelle C
authors: MC
authors: McKinley
authors: The Heart Centre, Belfast Health & Social Care Trust, Belfast, Northern Ireland; Centre for Medical Education, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.
authors: Mark T
authors: MT
authors: Harbinson
authors: Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland; The Heart Centre, Belfast Health & Social Care Trust, Belfast, Northern Ireland.
authors: Rebecca L
authors: RL
authors: Noad
authors: The Heart Centre, Belfast Health & Social Care Trust, Belfast, Northern Ireland.
authors: Lynn H
authors: LH
authors: Dixon
authors: Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.
authors: Ann
authors: A
authors: McGinty
authors: Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.
authors: Charlotte E
authors: CE
authors: Neville
authors: Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.
authors: Jayne V
authors: JV
authors: Woodside
authors: The Heart Centre, Belfast Health & Social Care Trust, Belfast, Northern Ireland; Centre for Medical Education, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast, Northern Ireland.
authors: Pascal P
authors: PP
authors: McKeown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D019587:Dietary Supplements; D004311:Double-Blind Method; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000178:diet therapy* / Q000503:physiopathology; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D055118:Medication Adherence; D018977:Micronutrients / Q000008:administration & dosage*; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018977:Micronutrients
keywords: heart failure; micronutrient; nutrition