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Elevated homocysteine levels are associated with adverse cardiovascular events, and folic-acid therapy reduces homocysteine levels. In this open-label, prospective trial from the Netherlands, researchers randomized 593 consecutive outpatients with coronary-artery disease to folic acid (0.5 mg daily) or to standard care. All had been taking statins for at least 3 months.
The 2 groups had similar baseline characteristics, including mean plasma homocysteine levels of 12 µmol/L. By 3 months, homocysteine levels had decreased among folic-acid recipients (by 18%) but not among controls. By a mean follow-up of 24 months, clinical vascular events (i.e., death, myocardial infarction, stroke, invasive coronary procedures, vascular surgery) had occurre…