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Coronary blood flow in patients with stable coronary artery disease treated long term with folic acid and vitamin B12.
MedLine Citation:
PMID:  21389855     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Plasma concentration of total homocysteine is associated with risk of cardiovascular disease in epidemiological studies. We wanted to examine the effects of B-vitamin therapy, which may lower total homocysteine, on coronary flow and vascular function in patients with established coronary artery disease (CAD). METHODS: Forty patients with stable CAD, mean (standard deviation) aged 57.8 (9.0) years, recruited into the Western Norway B-Vitamin Intervention Trial, were randomly assigned to daily oral treatment with 0.8 mg of folic acid and 0.4 mg of vitamin B12 or placebo, and 40 mg of vitamin B6 or placebo, using a 2×2 factorial design. At baseline, and after 9 and 24 months, coronary blood flow was assessed by coronary angiography and Doppler flow-wire measurements during intracoronary infusion of saline (basal), incremental doses of acetylcholine, adenosine, and nitroglycerin. RESULTS: We found a significant increase in basal (P<0.02) and adenosine-induced (P<0.05) coronary blood flow in patients who received folic acid/vitamin B12 for 24 months, compared with placebo or vitamin B6 alone. Folic acid/vitamin B12 or vitamin B6 treatment did not change endothelial-dependent response after acetylcholine infusion or flow-dependent proximal dilatation in response to adenosine-induced maximal hyperemia (P≥0.45). CONCLUSION: Long-term treatment with a combination of folic acid and vitamin B12 increase basal and adenosine-induced maximal coronary blood flow. This may reflect improved microvascular function in patients with stable CAD.
Authors:
Oyvind Bleie; Elin Strand; Per M Ueland; Stein E Vollset; Helga Refsum; Jannicke Igland; Jan E Nordrehaug; Ottar K Nygård
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-7
Journal Detail:
Title:  Coronary artery disease     Volume:  -     ISSN:  1473-5830     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aDepartment of Heart Disease, Haukeland University Hospital, Bergen bInstitute of Medicine cSection of Pharmacology, Institute of Medicine dDepartment of Public Health and Primary Health Care eUnifob Health, University of Bergen fDepartment of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway gDepartment of Pharmacology, University of Oxford, UK.
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