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Folate Linked to Fewer Deaths in Coronary Artery Disease

Patients with CAD, higher homocysteine taking vitamins had lower long-term all-cause mortality

THURSDAY, Sept. 24 (HealthDay News) -- 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, M.D., 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 ┬Ámol/L, treatment was associated with lower all-cause mortality (4 versus 32 percent), but was not in those with lower levels. In multivariate analysis, vitamin therapy was associated with a lower risk of all-cause mortality (hazard ratio, 0.33), and elevated homocysteine was associated with a higher risk (hazard ratio, 3.5). The MTHFR genotype was not linked to outcome.

"Our findings imply that patients with coronary artery disease should be screened for elevated fasting plasma homocysteine and that those with hyperhomocysteinemia may benefit from homocysteine-lowering vitamin therapy. Because we studied only patients with coronary artery disease, we cannot comment on the potential value of homocysteine-lowering therapy in all subjects with hyperhomocysteinemia," the authors conclude.

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