B Vitamin Regimen May Protect Heart

B Vitamin Regimen May Protect Heart

BERN, Switzerland--Supplementation with B vitamins may offer afeasible therapy for lowering homocysteine levels and thereby decreasing therisk of adverse events after corrective heart surgery, according to researchpublished in the Aug. 28 issue of the Journal of the American MedicalAssociation (JAMA) (288, 8:973-9, 2002) (www.jama.com).Researchers from Switzerland's University Hospital and colleagues from Clevelandand San Diego stated plasma homocysteine levels are an important risk inpatients with atherosclerosis and it influences the recurrence of arteryblockage after percutaneous coronary intervention (heart surgery).

To evaluate the effect of homocysteine-lowering therapy, researchers enrolled553 patients who were referred to University Hospital between May 1998 and April1999 after a successful angioplasty. Subjects were randomly assigned to receiveeither a B vitamin regimen--which included 1 mg/d of folic acid, 400 mcg/d ofvitamin B12 and 10 mg/d of vitamin B6--or placebo for six months. An additionalfollow-up occurred at one year. During both six-month periods, researchersrecorded the occurrence of major adverse events--defined as death, nonfatalmyocardial infarction and a need for repeat surgery.

After a mean follow-up of 11 months, 15.4 percent of the patients taking Bvitamins experienced a major coronary event, while 22.8 percent of the patientsin the placebo group experienced major adverse events. Researchers concluded thereduction of adverse events was primarily due to a reduced rate of target lesionrevascularization. In addition, death and nonfatal myocardial infarction wereslightly less likely to occur among patients taking B vitamins (2.6 percent)compared to those taking placebo (4.3 percent).

The same team of researchers reported similar findings in the Nov. 29, 2001,issue of the New England Journal of Medicine (29, 345: 1593-600, 2001).