09.01.03
Indication: Heart disease
Source: JACC, June 2003;41(12):
2105-2113.
Research: In this open-label study, 593 patients were included; 300 were randomized to folic acid and 293 served as controls. Mean follow-up time was 24 months. At baseline all patients had been on statin therapy for a mean of approximately three years.
Results: In patients treated with folic acid, plasma homocysteine levels decreased by 18%, whereas these levels remained unaffected in the control group. The primary end point was encountered in 31 patients in the folic acid group and in 28 patients in the control group. In a multifactorial survival model with adjustments for clinical factors, the most predictive laboratory parameters were, in order of significance, levels of creatinine clearance, plasma fibrinogen and homocysteine. The study’s authors concluded that within two years, folic acid does not seem to reduce clinical end points in patients with stable coronary artery disease (CAD), while on statin treatment. Homocysteine might therefore merely be a modifiable marker of disease. Thus, low-dose folic acid supplementation should be treated with reservation, until more trial outcomes become available.
Source: JACC, June 2003;41(12):
2105-2113.
Research: In this open-label study, 593 patients were included; 300 were randomized to folic acid and 293 served as controls. Mean follow-up time was 24 months. At baseline all patients had been on statin therapy for a mean of approximately three years.
Results: In patients treated with folic acid, plasma homocysteine levels decreased by 18%, whereas these levels remained unaffected in the control group. The primary end point was encountered in 31 patients in the folic acid group and in 28 patients in the control group. In a multifactorial survival model with adjustments for clinical factors, the most predictive laboratory parameters were, in order of significance, levels of creatinine clearance, plasma fibrinogen and homocysteine. The study’s authors concluded that within two years, folic acid does not seem to reduce clinical end points in patients with stable coronary artery disease (CAD), while on statin treatment. Homocysteine might therefore merely be a modifiable marker of disease. Thus, low-dose folic acid supplementation should be treated with reservation, until more trial outcomes become available.