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Does folate therapy reduce the risk of coronary restenosis?

E S van Hattum1, P A Doevendans, F L Moll

  • 1Department of Vascular Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands.

Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
|July 7, 2007
PubMed

Insights

Folate therapy may reduce coronary restenosis risk in some heart disease patients, but it can worsen in-stent restenosis after coronary stenting. Further research is needed before recommending folate for all patients.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Nutritional Science

Background:

  • Elevated homocysteine levels are a known risk factor for ischemic heart disease.
  • Folate therapy effectively lowers homocysteine levels.
  • The impact of folate therapy on coronary restenosis, particularly after interventions, requires clarification.

Purpose of the Study:

  • To evaluate the efficacy of folate therapy in reducing coronary restenosis in patients with coronary arterial disease.
  • To investigate potential adverse effects of folate therapy on restenosis rates, especially in stented arteries.

Main Methods:

  • A systematic literature search was conducted to identify relevant studies.
  • A critical appraisal of selected articles was performed to ensure evidence-based evaluation.
  • Three suitable studies were included to address the clinical query.

Main Results:

  • Folate therapy demonstrated a reduction in coronary restenosis rates.
  • This benefit was not observed in patients who underwent coronary stenting.
  • An adverse effect of folate therapy on in-stent restenosis was noted.

Conclusions:

  • The findings on folate therapy's effect on coronary restenosis after balloon angioplasty are conflicting.
  • Folate therapy may increase the risk of in-stent restenosis.
  • A conservative approach to folate therapy is recommended pending further clinical research.

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