Abstract | OBJECTIVES: BACKGROUND: METHODS: Fifteen patients scheduled for elective percutaneous transluminal coronary angioplasty (PTCA) with plasma homocysteine levels of >or=16 micromol/l were randomized for six months of treatment with folic acid 5 mg and cobalamin 400 microg daily or placebo. Coronary endothelial function was evaluated in a non-PTCA vessel using acetylcholine infusion in dosages of 10(-8) M, 10(-7) M, and 10(-6) M. Endothelium- dependent CBF is determined using intracoronary Doppler velocity and quantitative coronary angiography at baseline and after six months. RESULTS: In the folic acid/ cobalamin treated group, CBF increased after acetylcholine infusion with 96% (standard deviation 54; 95% confidence interval [CI]: 44% to 154%) compared with a decrease of 16% (standard deviation 35; 95% CI: -20% to +30%) of the CBF in the placebo-treated group (p < 0.005). CONCLUSIONS: This is the first prospective randomized placebo-controlled intervention study evaluating coronary endothelial function in hyperhomocysteinemic patients with CAD. Our results suggest that coronary endothelial function improves after treatment with folic acid and cobalamin.
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Authors | Frank F Willems, Wim R M Aengevaeren, Godfried H J Boers, Henk J Blom, Freek W A Verheugt |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 40
Issue 4
Pg. 766-72
(Aug 21 2002)
ISSN: 0735-1097 [Print] United States |
PMID | 12204509
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adult
- Aged
- Coronary Circulation
(drug effects, physiology)
- Coronary Disease
(complications, drug therapy, physiopathology)
- Coronary Vessels
(drug effects, physiopathology)
- Endothelium, Vascular
(drug effects, physiopathology)
- Female
- Folic Acid
(pharmacology, therapeutic use)
- Humans
- Hyperhomocysteinemia
(complications, drug therapy, physiopathology)
- Male
- Middle Aged
- Prospective Studies
- Vitamin B 12
(pharmacology, therapeutic use)
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