In this third up date of the Cochrane review , there were no differences in effects of homocysteine-lowering interventions in the form of supplements of vitamins B6 , B9 or B12 given alone or in combination comparing with placebo on myocardial infa rct ion , death from any cause or adverse events .
BACKGROUND Cardiovascular disease , which includes coronary artery disease , stroke and peripheral vascular disease , is a leading cause of death worldwide .
Homocysteine is an amino acid with biological functions in methionine metabolism .
A postulated risk factor for cardiovascular disease is an elevated circulating total homocysteine level .
The impact of homocysteine-lowering interventions , given to patients in the form of vitamins B6 , B9 or B12 supplements , on cardiovascular events has been investigated .
This is an up date of a review previously published in 2009 , 2013 , and 2015 .
OBJECTIVES To determine whether homocysteine-lowering interventions , provided to patients with and without pre-existing cardiovascular disease are effective in preventing cardiovascular events , as well as reducing all-cause mortality , and to evaluate their safety .
Effect of folic acid on endothelial function following acute myocardial infarction.
The aim of this study was to test the influence of high-dose folic acid ( 10 mg/d ) on endothelial function in patients referred for coronary intervention after an acute myocardial infa rct ion ( AMI ) and determine its relation to homocysteine levels . Flow-mediated dilation ( FMD ) of the brachial artery was performed in 40 patients after AMI ( 16 with normal homocysteine levels and 24 patients with elevated levels [ > 11 micromol/L ] ) . Subjects were r and omized to receive first folic acid ( 10 mg/day ; group A ) or placebo ( group B ) for 6 weeks in a double-blind crossover trial with a 2-week washout . Plasma folate , total homocysteine and its subtypes ( oxidized , reduced , and protein-bound ) , FMD , and nitroglycerin-mediated dilation were assessed at baseline and at 6 and 14 weeks . In group A , folic acid improved FMD from 3.98 + /- 0.35 % to 6.44 + /- 0.56 % ( p < 0.001 ) . This effect persisted after the crossover with placebo ( 5.42 + /- 0.59 , p = 0.13 ) . In group B , placebo did not increase FMD ( 4.01 + /- 0.34 % vs 4.46 + /- 0.38 , p = 0.38 ) ; however , a significant increase was observed in the second active treatment period ( 6.49 + /- 0.56 % , p = 0.005 ) . In both groups , improved FMD neither correlated with basal levels of homocysteine and its subtypes nor with changes induced during the folate treatment . Nitroglycerin-mediated dilation did not change significantly in either group . Folic acid increased FMD in both normo- and hyperhomocysteinanemic groups ( p = 0.006 and p < 0.001 ) . In conclusion , 6-week treatment with high-dose folic acid improves endothelial function in post-AMI patients , independent from homocysteine status . Folic acid can be recommended to improve postinfa rct ion endothelial dysfunction in patients with normo- and hyperhomocysteinemia
In this third up date of the Cochrane review , there were no differences in effects of homocysteine-lowering interventions in the form of supplements of vitamins B6 , B9 or B12 given alone or in combination comparing with placebo on myocardial infa rct ion , death from any cause or adverse events .
BACKGROUND Cardiovascular disease , which includes coronary artery disease , stroke and peripheral vascular disease , is a leading cause of death worldwide .
Homocysteine is an amino acid with biological functions in methionine metabolism .
A postulated risk factor for cardiovascular disease is an elevated circulating total homocysteine level .
The impact of homocysteine-lowering interventions , given to patients in the form of vitamins B6 , B9 or B12 supplements , on cardiovascular events has been investigated .
This is an up date of a review previously published in 2009 , 2013 , and 2015 .
OBJECTIVES To determine whether homocysteine-lowering interventions , provided to patients with and without pre-existing cardiovascular disease are effective in preventing cardiovascular events , as well as reducing all-cause mortality , and to evaluate their safety .