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Effect of homocysteine-lowering B vitamin treatment on angiographic progression of coronary artery disease: a Western Norway B Vitamin Intervention Trial (WENBIT) substudy
- Source :
- The American journal of cardiology. 105(11)
- Publication Year :
- 2009
-
Abstract
- Total plasma homocysteine (tHcy) is an independent risk factor for coronary artery disease, and tHcy is lowered by B vitamins. To assess the effect of homocysteine-lowering B-vitamin treatment on angiographic progression of coronary artery disease, this substudy of the Western Norway B Vitamin Intervention Trial (WENBIT) included patients who had undergone percutaneous coronary intervention. The patients were randomized to daily oral treatment with folic acid, vitamin B(12), and vitamin B(6) or placebo in a 2 x 2 factorial design. The coronary angiograms obtained at baseline and follow-up were evaluated. The primary angiographic end points were the changes in minimum lumen diameter and diameter stenosis. A total of 348 subjects (288 men) with a mean +/- SD age of 60 +/- 10.2 years were followed up for a median of 10.5 months (twenty-fifth, seventy-fifth percentile 9.2, 11.8). The baseline median plasma tHcy level was 10.0 mumol/L (twenty-fifth, seventy-fifth percentile 8.1, 11.0), and treatment with folic acid/vitamin B(12) lowered the tHcy levels by 22%. At follow-up, we found 309 lesions with a significant decrease from baseline in the minimum lumen diameter of a mean of -0.16 +/- 0.4 mm and an increase in the diameter stenosis of 4.4 +/- 0.7%. Treatment with folic acid/vitamin B(12) or vitamin B(6) was not associated with a change in diameter stenosis or minimum lumen diameter. In a post hoc analysis, folic acid/vitamin B(12) treatment was significantly associated with rapid progression (odds ratio 1.84, 95% confidence interval 1.07 to 3.18). In conclusion, vitamin B treatment showed no beneficial effect on the angiographic progression of coronary artery disease, and the post hoc analyses suggested that folic acid/vitamin B(12) treatment might promote more rapid progression.
- Subjects :
- Male
medicine.medical_specialty
Homocysteine
medicine.medical_treatment
Coronary Artery Disease
Placebo
Coronary Angiography
Gastroenterology
Coronary artery disease
chemistry.chemical_compound
Folic Acid
Internal medicine
Angioplasty
Medicine
Humans
Risk factor
Angioplasty, Balloon, Coronary
Aged
business.industry
Norway
Percutaneous coronary intervention
Odds ratio
Middle Aged
medicine.disease
Vitamin B 6
Surgery
B vitamins
Vitamin B 12
chemistry
Vitamin B Complex
Cardiology
Disease Progression
Female
Cardiology and Cardiovascular Medicine
business
Biomarkers
Follow-Up Studies
Subjects
Details
- ISSN :
- 18791913
- Volume :
- 105
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- The American journal of cardiology
- Accession number :
- edsair.doi.dedup.....1426639a3ef77030833d35535f702b18