Decreased rate of coronary restenosis after lowering of plasma homocysteine levels

Area of Science:

• Cardiology
• Vascular Biology
• Nutritional Science

Background:

• Elevated plasma homocysteine is linked to restenosis post-percutaneous coronary angioplasty.
• Previous studies indicated an association between high homocysteine and restenosis.
• This study aimed to investigate if reducing homocysteine levels impacts restenosis rates.

Purpose of the Study:

• To evaluate the efficacy of lowering plasma homocysteine levels on restenosis after coronary angioplasty.
• To assess the impact of folate treatment on restenosis and major adverse cardiac events.

Main Methods:

• A prospective, double-blind, randomized trial involving 205 patients.
• Patients received either folate treatment (folic acid, vitamin B12, pyridoxine) or placebo for six months post-angioplasty.
• Restenosis was assessed by quantitative coronary angiography; major adverse cardiac events were secondary endpoints.

Main Results:

• Folate treatment significantly reduced plasma homocysteine levels.
• Patients receiving folate treatment had a larger minimal luminal diameter and less severe stenosis at follow-up.
• The rate of restenosis (19.6% vs. 37.6%) and target lesion revascularization (10.8% vs. 22.3%) were significantly lower in the folate group.

Conclusions:

• Combination folate therapy effectively lowers homocysteine levels.
• This treatment significantly decreases restenosis and the need for revascularization after coronary angioplasty.
• Inexpensive folate therapy with minimal side effects is a viable adjunctive treatment for patients undergoing coronary angioplasty.