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Therapeutics
Homocysteine lowering treatment improved outcomes after percutaneous coronary intervention

https://doi.org/10.1136/ebm.8.2.48

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    (2002) JAMA 288, 973; Schnyder G, Roffi M, Flammer Y, et al.. Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: the Swiss Heart study: a randomized controlled trial.. ;. :. –9.
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 QUESTION: In patients having percutaneous coronary intervention (PCI), does homocysteine lowering treatment with folic acid, vitamin B12, and vitamin B6 reduce adverse coronary outcomes?

    Design

    Randomised (unclear allocation concealment*), blinded (clinicians, patients, and outcome assessors),* placebo controlled trial with 12 months of follow up.

    Setting

    A university hospital in Bern, Switzerland.

    Patients

    553 patients (mean age 63 y, 80% men) who received angioplasty to treat at least 1 significant coronary stenosis (≥50%). Exclusion criteria were unstable angina, myocardial infarction (MI) within the past 2 weeks, renal insufficiency, or receipt of vitamin supplements. Follow up was 83%; all patients were included in the analysis.

    Intervention

    Patients were allocated to homocysteine lowering treatment with folic acid, 1 mg/day; vitamin B12, …

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    Footnotes

    • For correspondence: Dr G Schnyder, UCSD Medical Center, San Diego, CA, USA. g.schnyder{at}lycos.com

    • Abstract and commentary also appear in ACP Journal Club.

    • Source of funding: Swiss National Science Foundation.

    • ↵*See glossary.