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Homocysteine--a treatable risk factor for allograft vascular disease after heart transplantation?

I Kutschka1, K Pethig, M Strüber

  • 1Department of Thoracic and Cardiovascular Surgery, Division of Surgery, Hannover Medical School, Hannover, Germany. kutschka@thg.mh-hannover.de

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|July 13, 2001
PubMed

Insights

Folic acid supplementation significantly lowers elevated total plasma homocysteine (tHCY) levels in heart transplant recipients. This simple intervention effectively reduces tHCY within three months, aiding post-transplant care.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Nutritional Science

Background:

  • Elevated total plasma homocysteine (tHCY) is linked to cardiac allograft vasculopathy after heart transplantation.
  • Managing tHCY may improve outcomes in heart transplant recipients.

Purpose of the Study:

  • To evaluate the efficacy of folic acid supplementation in reducing tHCY levels in heart transplant patients.
  • To assess the impact of daily folic acid on established tHCY levels.

Main Methods:

  • A prospective study involving 69 heart transplant recipients.
  • Patients received either 5 mg of folic acid daily (n=34) or no medication (control group, n=35).
  • tHCY levels were measured before and after a 3-month intervention period.

Main Results:

  • Folic acid therapy led to a significant reduction in tHCY levels (22.6 to 17.3 micromol/liter, p=0.001).
  • The control group showed no significant change in tHCY levels.
  • A 5 mg daily dose of folic acid was effective within 3 months.

Conclusions:

  • Folic acid supplementation is a simple and effective strategy to lower elevated tHCY levels in heart transplant recipients.
  • This intervention holds potential for improving long-term outcomes by managing tHCY.
  • Daily folic acid at 5 mg is recommended for heart transplant patients with elevated tHCY.

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