Mortality and Cardiovascular Events in Patients Treated With Homocysteine-Lowering B Vitamins After Coronary Angiography

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Abstract
Observational studies have demonstrated that the concentration of total homocysteine in blood is associated with risk of coronary artery disease (CAD) and stroke.1,2 In prospective cohort studies from western Norway, plasma total homocysteine concentration was found to be a strong predictor of mortality both in patients with CAD3 and those with aortic valve stenosis.4 Because plasma total homocysteine levels can be easily lowered by oral administration of folic acid, trials to investigate whether cardiovascular disease (CVD) could be prevented by such homocysteine-lowering therapy were called for. Furthermore, observational studies have found inverse associations between vitamin B6 intake and risk of future CAD5 and between circulating vitamin B6 concentration and risk of CVD, independent of plasma total homocysteine concentration.6