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Homocysteine-lowering therapy and long-term prognosis after elective percutaneous coronary intervention

Author(s): O.O. Shakhmatova | A.L. Komarov | A.N. Samko | T.I. Kotkina | D.V. Rebrikov | A.D. Deev | E.P. Panchenko

Journal: Racionalʹnaâ Farmakoterapiâ v Kardiologii
ISSN 1819-6446

Volume: 7;
Issue: 5;
Start page: 524;
Date: 2011;
Original page

Keywords: homocysteine | folic acid | vitamin B12 | percutaneous coronary intervention.

Aim. To evaluate the effect of FA, B6 and B12 vitamins (in doses approximate to daily maintenance) on long-term prognosis after elective percutaneous coronary intervention (PCI) in stable ischemic heart disease patients.Material and methods. 264 patients (213 male, age 58.8±1.0 years) after successful PCI were involved into the trial. Patients with clinical signs of the vitamins deficiency were not included. Patients were randomly assigned to receive combination of FA (0.6 mg/day), B12 (10 μg/day), and B6 (4 mg/day) vitamins along with the conventional therapy (n=97) or the conventional therapy only (n=167) for 20 months. The groups were comparable in age, gender and prevalence of coronary risk factors. Composite endpoint was defined as cardiovascular death, acute coronary syndrome, stroke or transient ischemic attack and need for coronary/carotid revascularization.Results. The vitamins prescription to all of the patients did not reduce composite endpoint incidence according to multivariable regression analysis (RR 0,7; 95%CI 0,4-1,4; p=0,3). Subgroup analysis showed significantly lower composite endpoint incidence in patients who received vitamins and had initially low B12 blood level (
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