Effect of Folic acid on Serum Homocysteine and Morbidity in Patients with Chronic Coronary Artery Disease

In addition to traditional cardiovascular risk factors, high levels of plasma homocysteine has been documented recently as independent risk factors for atherosclerosis. The probable mechanism is through endothelial dysfunction. Roughly 10% of the population with coronary artery disease (CAD) may have hyper-homocysteinemia. Since folic acid is a potential factor in lowering plasma homocysteine and dietary intake of folic acid is not sufficient, it needs to be prescribed to CAD patients as a supplement. The purpose of this study is to assess the effect of folic acid on plasma homocysteine levels and on morbidity in stable CAD patients.
In this prospective interventional study, we recruited 52 stable CAD patients; the plasma levels of homocysteine, folic acid and vitamin B12 were measured. The morbidity-related indices (the number of sublingual TNGs per week, typical anginal chest pain per week, the number of cardiovascular-related hospitalizations in the previous 3 months, functional class and ECG changes) were determined. All patients received 2 mg oral folic acid daily for 3 months. At the end of the study, the level of homocysteine and morbidity were determined. Effect of Folic Acid on Homocysteine and Morbidity in CAD F. Jalali MD, et al.
Folic acid supplementation for 3 months was associated with a decrease in homocysteine level by 44% (P=0.000). We did not observe a significant change in levels of serum folic acid. There were significant declines in all morbidity indices including TNG consumption, frequency of chest pain, functional class and hospitalizations (P=0.001).
The findings indicate that 2 mg folic acid orally daily for 3 months is associated with a decrease in homocysteine level and morbidity in CAD patients