Should patients with coronary disease and high homocysteine take folic acid?

All patients with known coronary artery disease should take prescription strength (1 mg/d) folic acid, vitamin B₁₂ (400 μg/d), and vitamin B₆ (10 mg/d), which have few if any known adverse effects. In this study, therapy to reduce homocysteine levels with prescription strength folic acid (1 mg) and vitamins B₁₂ and B₆ for 6 months following coronary angioplasty reduced the risk of need for revascularization of target lesions and of overall adverse cardiac events at least 6 months following cessation of therapy.

Based on this study, it is unknown whether the benefit is related to baseline homocysteine levels or whether there is further benefit to continuing treatment beyond 6 months. Over-the-counter folic acid supplements (800 μg or less) were not studied and may not be as beneficial.

All patients with known coronary artery disease should take prescription strength (1 mg/d) folic acid, vitamin B₁₂ (400 μg/d), and vitamin B₆ (10 mg/d), which have few if any known adverse effects. In this study, therapy to reduce homocysteine levels with prescription strength folic acid (1 mg) and vitamins B₁₂ and B₆ for 6 months following coronary angioplasty reduced the risk of need for revascularization of target lesions and of overall adverse cardiac events at least 6 months following cessation of therapy.

Based on this study, it is unknown whether the benefit is related to baseline homocysteine levels or whether there is further benefit to continuing treatment beyond 6 months. Over-the-counter folic acid supplements (800 μg or less) were not studied and may not be as beneficial.

All patients with known coronary artery disease should take prescription strength (1 mg/d) folic acid, vitamin B₁₂ (400 μg/d), and vitamin B₆ (10 mg/d), which have few if any known adverse effects. In this study, therapy to reduce homocysteine levels with prescription strength folic acid (1 mg) and vitamins B₁₂ and B₆ for 6 months following coronary angioplasty reduced the risk of need for revascularization of target lesions and of overall adverse cardiac events at least 6 months following cessation of therapy.

Based on this study, it is unknown whether the benefit is related to baseline homocysteine levels or whether there is further benefit to continuing treatment beyond 6 months. Over-the-counter folic acid supplements (800 μg or less) were not studied and may not be as beneficial.