any evidence links hyperhomocystine...

any evidence links hyperhomocystinemia and coronary artery disease. Folate supplementation decreases homocysteine flushs but clinical trials of supplementation to stop restenosis after angioplasty have produc conflicting accrues Lange and colleagues conducted a trial of folate supplementation after angioplasty and coronary placement.

This randomized, double-blind, placebo-control l cogitation enlisted 636 patients who had not long ago had successful coronary artery s placement. Post-procedure, participants were randomized to placebo or folate therapy (intravenous bolus followed by the agency of oral maintenance therapy with 1 2 mg of folic acid, 48 mg of vitamin [Bsub6] and 60 mcg of vitamin [Bsub12]) Homocysteine flats and a repeat coronary angiogram were checked after six month of treatment. Revascularization performances were performed if needed in succession the originally stented vessel, according to predetermined clinical criteria.

Clopidogrel therapy was used for four weeks after stenting in all enthralls and daily aspirin use continued quite through the study period. Approximately 40 percent of make submissives in both groups were taking a statin medication during the trial. Of the 636 originally enlisted patients, 14 percent did not total the six months of supplementation, and a further 10 percent declined to have follow-up angiography.

Homocysteine flats declined significantly in those randomized to folate therapy (from a baseline average of 122 [micro]mol by L to 9. 0 [micro]mol through L at six months) Repeat angiography at six month showed a smaller coronary artery diameter in the ed target vessel among those receiving active medication, compared with placebo recipients. A nonsignificant direction toward a greater need for target-vessel revascularization was noted in those taking folate addition s No significant difference in rates of death or myocardial infarction was noted in the brace treatment arms of the study

Subgroup analysis showed that patients with diabetes and those with higher baseline homocysteine plains had a somewhat lowered risk of restenosis with folate therapy. An accompanying editiorial notes that the previously heralded benefit of folate supplementation that was reported in the Swiss Heart subject of attention was restricted largely to those who had balloon angioplasty without placement, a practice that is no longer common

The authors decide that folate therapy after coronary stenting is not helpful in reducing restenosis and may be harmful.

Lange H et al. Folate therapy and in-stent restenosis after coronary stenting. N Engl J M June 24 2004;350:267381 and Herrmann HC Prevention of cardiovascular affairs after percutaneous coronary intervention [Editorial]. N Engl J M June 24 2004;350:2708-10

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