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Because high plasma total homocysteine levels are associated with vascular disease, researchers are examining whether homocysteine-lowering therapy improves clinical outcomes. In recent trials, folic acid reduced the restenosis rate after coronary angioplasty (Journal Watch Sep 6 2002), but it did not prevent vascular events in patients with stable coronary disease (Journal Watch Aug 15 2003).
In this multicenter double-blind randomized study, researchers enrolled 3680 patients with nondisabling, nonembolic ischemic strokes and total homocysteine levels above the 25th percentile for the North American stroke population. Patients received either high doses of homocysteine-lowering vitamins (2.5 mg folic acid, 25 mg pyridoxine, and 0.4 mg coba…