An increased plasma homocysteine concentration is a risk factor for atherosclerosis. Folic acid lowers homocysteine but the optimal dose in patients with coronary artery disease (CAD) is unclear. This placebo- controlled, single-blind, dose-ranging study evaluates the effect of low- dose folic acid on homocysteine levels in 95 patients aged 61 ± 11 years (mean ± SD) with documented CAD. Patients in each group were given either placebo or 1 of 3 daily supplements of folic acid (400 μg, 1 mg, or 5 mg) for 3 months. Each active treatment arm also received 500 μg vitamin B12 and 12.5 mg vitamin B6. Total plasma homocysteine levels were measured after 30 and 90 days. Folic acid 400 μg reduced homocysteine levels from 13.8 ± 8.8 to 9.6 ± 2.0 μmol/L at 90 days (p = 0.001). On 1- and 5-mg folic acid, levels decreased from 13.0 ± 6.4 to 9.8 ± 4.0 μmol/L (p = 0.001) and from 14.8 ± 6.9 to 9.7 ± 3.3 μmol/L (p <0.001), respectively. The decrease was similar in all treatment groups. There was no significant change with placebo. Although the sample size is small, these findings suggest that daily administration of 400 μg/day folic acid combined with vitamin B12 and vitamin B6 may be equivalent to higher doses in reducing homocysteine levels in patients with CAD.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine