Abstract
Background and Objectives: Elevated plasma homocysteine concentrations are recognized as a risk factor for coronary artery disease and are inversely related to plasma and foliate and vitamin B12 levels. Considering that, the most performed studies have assessed the effect of different doses of folic acid with other vitamins on plasma homocysteine levels and the other hands, nutritional status that is the important factor in determining of plasma homocysteine levels has not been considered. Therefore, the present study was done to assess the effect of supplementation of the folic acid on homocysteine levels in patients with coronary artery disease (CAD).
Materials and Methods: This study was a double-blind, placebo-controlled trial that was conducted on 70 male patients aged 45-65 years with documented CAD. Patients were divided randomly into two groups (folic acid or placebo group) which received respectively 1 mg folic acid or placebo tablets daily for 8 weeks. Before and after intervention period, fasting blood samples were taken for measurement of homocysteine and foliate levels.
Results: During 8 weeks supplementation with folic acid, foliate concentration significantly increased in the folic acid group (P< 0.001). Increased rate of serum foliate was higher in patients with initial serum foliate < 5 ng/ml than other groups (P = 0.04).
The mean plasma total homocysteine concentration after 8 weeks of supplementation with folic acid significantly decreased (P < 0.001). Decreased rate of plasma total homocysteine concentration was higher in patients with initial plasma total homocysteine > 30 µmol/L than other groups (P = 0.002).
There was no significant change with placebo. Supplementation with folic acid normalized plasma total homocysteine levels (<15µmol/L) in 50 percent of hyperhomocysteinemic patients.
Conclusion: These findings suggest that daily administration of 1 mg folic acid effectively reduced plasma homocysteine concentration in CAD patients. Therefore, in CAD patients with high homocysteine levels supplementation with folic acid is recommended.