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The use of folate may reduce the long-term risk of death in patients with coronary artery disease and elevated homocysteine.
The use of folate may reduce the long-term risk of death in patients with coronary artery disease and elevated homocysteine, according to research published in the Sept. 15 issue of the American Journal of Cardiology.
Aviv Mager, MD, of the Rabin Medical Center in Petah Tikva, Israel, and colleagues analyzed data from 492 subjects with coronary artery disease. Some patients were given daily folic acid, with or without additional B vitamins, at the attending physician's choice. Patients were genotyped for the C677T mutation in the MTHFR gene or were screened for elevated homocysteine levels, and were followed for a median of 115 months.
The researchers found that, in subjects with homocysteine levels above 15 μmol/L, treatment was associated with lower all-cause mortality (4% vs. 32%), but was not in those with lower levels. In multivariate analysis, vitamin therapy was associated with a lower risk of all-cause mortality (HR, 0.33), and elevated homocysteine was associated with a higher risk (HR, 3.5). The MTHFR genotype was not linked to outcome.
Mager A, Orvin K, Koren-Morag N, et al. , Impact of homocysteine-lowering vitamin therapy on long-term outcome of patients with coronary artery disease. Am J Cardiol. 2009;15: 745-749.