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 .
Coronary blood flow in patients with stable coronary artery disease treated long term with folic acid and vitamin B12
Background Plasma concentration of total homocysteine is associated with risk of cardiovascular disease in epidemiological studies . We wanted to examine the effects of B-vitamin therapy , which may lower total homocysteine , on coronary flow and vascular function in patients with established coronary artery disease ( CAD ) . Methods Forty patients with stable CAD , mean ( st and ard deviation ) aged 57.8 ( 9.0 ) years , recruited into the Western Norway B-Vitamin Intervention Trial , were r and omly assigned to daily oral treatment with 0.8 mg of folic acid and 0.4 mg of vitamin B12 or placebo , and 40 mg of vitamin B6 or placebo , using a 2 × 2 factorial design . At baseline , and after 9 and 24 months , coronary blood flow was assessed by coronary angiography and Doppler flow-wire measurements during intracoronary infusion of saline ( basal ) , incremental doses of acetylcholine , adenosine , and nitroglycerin . Results We found a significant increase in basal ( P<0.02 ) and adenosine-induced ( P<0.05 ) coronary blood flow in patients who received folic acid/vitamin B12 for 24 months , compared with placebo or vitamin B6 alone . Folic acid/vitamin B12 or vitamin B6 treatment did not change endothelial-dependent response after acetylcholine infusion or flow-dependent proximal dilatation in response to adenosine-induced maximal hyperemia ( P≥0.45 ) . Conclusion Long-term treatment with a combination of folic acid and vitamin B12  increase basal and adenosine-induced maximal coronary blood flow . This may reflect improved microvascular function in patients with stable CAD
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 .