Dose-dependent effects of folic acid on plasma homocysteine in a randomized trial conducted among 723 individuals with coronary heart disease

被引：21

作者：

Dudman N. ^{[1
,2
]}

Hunt D. ^{[1
,2
]}

MacMahon S. ^{[1
,2
]}

Neal B. ^{[1
]}

Richards M. ^{[1
]}

Simes J. ^{[1
]}

Tonkin A. ^{[1
]}

Wilcken D. ^{[1
]}

Murphy J. ^{[1
]}

Cleverly Y. ^{[1
]}

Keech A. ^{[1
]}

Ohkubo T. ^{[1
]}

Bos K. ^{[1
]}

Bartram H. ^{[1
]}

Bennett D. ^{[1
]}

Broad J. ^{[1
]}

Douglas D. ^{[1
]}

Fisher S. ^{[1
]}

Gray B. ^{[1
]}

Milne A. ^{[1
]}

McCulloch A. ^{[1
]}

Ng C. ^{[1
]}

Pledger M. ^{[1
]}

Pryor A. ^{[1
]}

Santos A. ^{[1
]}

Slater A. ^{[1
]}

Yiu K. ^{[1
]}

Brnabic A. ^{[1
]}

Woodward M. ^{[1
]}

Burrell L. ^{[1
]}

Brown L. ^{[1
]}

Hamer A. ^{[1
]}

Roberts L. ^{[1
]}

Jeffery I. ^{[1
]}

Taverner P. ^{[1
]}

Kam A. ^{[1
]}

Aylward P. ^{[1
]}

Wollaston F. ^{[1
]}

Whitehead A. ^{[1
]}

Lane G. ^{[1
]}

Tulloch G. ^{[1
]}

Forrest N. ^{[1
]}

Garrett J. ^{[1
]}

Aroney G. ^{[1
]}

Hicks P. ^{[1
]}

Silberberg J. ^{[1
]}

Gordon A. ^{[1
]}

Holliday J. ^{[1
]}

Hicks L. ^{[1
]}

Singh B. ^{[1
]}

机构：

[1] Univ Sydney, Inst Int Hlth, Sydney, NSW 2042, Australia

来源：

EUROPEAN HEART JOURNAL | 2002年 / 23卷 / 19期

关键词：

homocysteine; folic acid; coronary heart disease; randomized trial;

D O I：

10.1053/euhj.2002.3161

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims To determine the effects on homocysteine levels of two doses of folic acid compared to placebo, where the high dose is typical of that provided by pharmacological intervention and the low dose approximates that provided by dietary supplementation. Methods and Results The PACIFIC study was a double-blind, placebo-controlled, factorial randomized trial. Seven hundred and twenty-three individuals with a history of myocardial infarction or unstable angina were recruited from 28 clinical cardiology centres in Australia and New Zealand and randomized to folic acid 2.0 mg daily, folic acid 0.2 mg daily or placebo. The primary outcome, homocysteine, was measured using a fluorescence polarization immunoassay. Compared to placebo, 2.0 mg folic acid reduced homocysteine by 1.8 mumol . 1(-1) [95% confidence interval (CI) 1.3-2.3] and 0.2 mg reduced homocysteine by 1.2 mumol . 1(-1) (95% Cl 0.8-1.7). The higher dose reduced homocysteine significantly more than the lower dose (P=0.01). Conclusions Both doses of folic acid reduced homocysteine, but the effects of the 2.0 mg dose were about one third greater than the 0.2 mg dose. Fortification of foods with folic acid should result in population-wide lower levels of homocysteine but high-dose pharmacological supplementation would produce greater reductions for high-risk individuals. (C) 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.

引用

页码：1509 / 1515

页数：7

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