Homocysteine Lowering and Restenosis After Coronary Angioplasty

Plasma homocysteine levels are associated with vascular disease in various populations. A Swiss team recently observed that restenosis after coronary angioplasty was more likely in patients with high homocysteine levels. In this study, the team posed the next logical question: Does an intervention to lower plasma homocysteine reduce the rate of restenosis?

A total of 205 patients who underwent successful coronary angioplasty were randomized to receive either homocysteine-lowering therapy (1 mg folic acid, 400 μg vitamin B₁₂, and 10 mg pyridoxine) or placebo. At 6 months, patients in the active-treatment group were significantly less likely than placebo recipients to have angiographic restenosis (20 percent vs. 38 percent) or to have undergon…