Vitamins lower levels of total plasma homocysteine, don't slow progression after PCI
WEDNESDAY, June 9 (HealthDay News) -- In patients with coronary artery disease (CAD) who have undergone percutaneous coronary intervention (PCI), subsequent therapy with folic acid/vitamin B12 lowers levels of total plasma homocysteine (tHcy) but does not have a beneficial effect on disease progression, according to a study in the June 1 issue of the American Journal of Cardiology.
Kjetil H. Løland, of the University of Bergen in Norway, and colleagues studied 348 CAD patients who had been randomized to daily oral doses of folic acid, vitamin B12, and vitamin B6 or placebo in a 2 × 2 factorial design. The researchers followed the subjects for a mean 10.5 months, evaluating baseline tHcy and follow-up tHcy and comparing baseline and follow-up angiograms for changes in minimum lumen diameter and diameter stenosis.
The researchers found that the baseline median tHcy level was 10.0 µmol/L, which treatment with folic acid/vitamin B12 reduced by 22 percent. However, follow-up angiograms revealed 309 lesions with a mean −0.16 mm decrease in minimum lumen diameter from baseline, and an increase in diameter stenosis of 4.4 percent. In subsequent analysis, the researchers found folic acid/vitamin B12 treatment was significantly associated with rapid disease progression (odds ratio, 1.84).
"In conclusion, vitamin B treatment showed no beneficial effect on the angiographic progression of CAD, and the post hoc analyses suggested that folic acid/vitamin B12 treatment might promote more rapid progression," the authors write.
The research was a substudy of the Western Norway B Vitamin Intervention Trial, which was funded in part by Alpharma Inc.
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