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Although high blood levels of homocysteine are associated with increased risk for cardiovascular disease, whether lowering homocysteine with folic acid and B vitamins might improve outcomes remains unclear. Therefore, investigators in Norway assessed the effect of treatment with folic acid and vitamins B12 and B6 on secondary events in patients undergoing angiography for coronary artery disease or aortic stenosis.
The study cohort consisted of 3090 adults (average age, 62; 20% women) randomized in a 2 x 2 factorial design to daily oral treatment with folic acid (0.8 mg) plus vitamins B12 (0.4 mg) and B6 (40 mg); folic acid plus vitamin B12; vitamin B6 alone; or placebo. The primary outcome of interest was a composite of all-cause death, nonf…