Folic acid influences plasma homocysteine levels and arterial endothelial function in patients with unstable angina

Abstract

Objective High plasma homocysteine (Hcy) levels are associated with coronary artery disease, but the precise level associated with an increased risk is yet controversial. Whether the beneficial effects of folic acid on arterial endothelial function persist over longer periods is not known. This study aimed to assess whether folic acid supplementation could produce improvements in Hcy levels and arterial endothelial function in the patients with unstable angina (UA) and hyperhomocysteinemia. Design and method The plasma Hcy levels of 52 cases with UA and 30 age and sex-matched control subjects were measured by using high-performance liquid chromatography (HPLC) with fluorescence detection, plasma folic acid and VitB12 levels were measured with immunoassay. The patients with hyperhomocysteinemia were treated with 5 mg of folic acid for 8 weeks, and then rechecked the plasma levels of Hcy, folic acid and VitB12 at the end of the 4th and 8th weeks. Arterial endothelial function was measured as flow-mediated dilation of the brachial artery using high-resolution B-mode ultrasound in 22 cases with UA and hyperhomocysteinemia. Conclusions Hcy level is elevated in patients with UA. Folic acid can reduce the plasma Hcy levels and improve arterial endothelial function in the UA patients with hyperhomocysteinemia. Objective High plasma homocysteine (Hcy) levels are associated with coronary artery disease, but the precise level associated with an increased risk is yet controversial. Whether the beneficial effects of folic acid on arterial endothelial function persist over longer periods is not known. This study aimed to assess whether folic acid supplementation could produce improvements in Hcy levels and arterial endothelial function in the patients with unstable angina (UA) and hyperhomocysteinemia. Design and method The plasma Hcy levels of 52 cases with UA and 30 age and sex-matched control subjects were measured by using high-performance liquid chromatography (HPLC) with fluorescence detection, plasma folic acid and VitB12 levels were measured with immunoassay. The patients with hyperhomocysteinemia were treated with 5 mg of folic acid for 8 weeks, and then rechecked the plasma levels of Hcy, folic acid and VitB12 at the end of the 4th and 8th weeks. Arterial endothelial function was measured as flow-mediated dilation of the brachial artery using high-resolution B-mode ultrasound in 22 cases with UA and hyperhomocysteinemia. Conclusions Hcy level is elevated in patients with UA. Folic acid can reduce the plasma Hcy levels and improve arterial endothelial function in the UA patients with hyperhomocysteinemia.