Last Updated: 2002-09-18 17:46:31 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Treatment with folic acid and cobalamin appears to improve coronary endothelial function in hyperhomocysteinemic patients with coronary artery disease, according to Dutch researchers.

In the August 21st issue of the Journal of the American College of Cardiology, Dr. Frank F. Willems of University Medical Center, Nijmegen, and colleagues note that "it has been unclear whether homocysteine-lowering therapy improves coronary endothelial function."

To investigate, the researchers studied 15 patients with hyperhomocysteinemia and coronary artery disease. They were randomized to daily treatment with folic acid 5 mg in combination with cobalamin 400 mcg or to placebo.

At the end of the 6-month study, homocysteine levels fell by 31% in the combination group, but did not change in placebo patients.

At baseline all patients showed severe coronary endothelial dysfunction after acetylcholine infusion. There was a significant improvement in coronary blood flow after the combination therapy. Placebo patients showed a 16% decrease in coronary blood flow, whereas combination patients demonstrated a 96% increase.

"Coronary endothelial dysfunction predicts cardiovascular mortality, and we were able to demonstrate that folic acid and cobalamin can improve coronary endothelial function," Dr. Willems told Reuters Health.

J Am Coll Cardiol 2002;40:766-772.