Reducing new risk markers (Re: Intensive Lipid Lowering with Atorvastatin)

From: Juhana Harju (shantigiri_at_despammed.com)
Date: 03/12/05 

Date: Sat, 12 Mar 2005 09:49:13 +0200

Jim Chinnis wrote:
:: "Juhana Harju" <shantigiri@despammed.com> wrote in part:
::
::: David Rind wrote:

::::: For instance, we do not know that reducing homocysteine
::::: levels or CRP decreases cardiac mortality even though they are
::::: risk factors for cardiac events.
:::
::: I thought that there is already some evidence that treating
::: homocysteine reduces adverse cardiac events. There is the study
::: done with healthy siblings published in Lancet where homocysteine
::: reducing vitamin therapy reduced sub-clinical atheroschlerosis and
::: I recall that there are also some Swiss studies about reduced
::: cardiac events by homocysteine lowering therapy. However, I admit
::: that when it comes to strokes the interventions have failed.
::
:: I think the study results aren't consistent.

Perhaps not unequivocally consistent but the evidence is building up:

(1) Schnyder G 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. JAMA. 2002 Aug 28;288(8):973-9.

"Homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin
B6 significantly decreases the incidence of major adverse events after
percutaneous coronary intervention."

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12190367

(2) Schnyder G at al, Decreased Rate of Coronary Restenosis after
Lowering of Plasma Homocysteine Levels. New England Journal of Medicine
2001;345:1593-1600

"Treatment with a combination of folic acid, vitamin B12, and pyridoxine
significantly reduces homocysteine levels and decreases the rate of
restenosis and the need for revascularization of the target lesion after
coronary angioplasty. This inexpensive treatment, which has minimal side
effects, should be considered as adjunctive therapy for patients
undergoing coronary angioplasty."

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11757505

(3)Vermeulen EG et al, Effect of homocysteine-lowering treatment with
folic acid plus vitamin B6 on progression of subclinical
atherosclerosis: a randomised, placebo-controlled trial. Lancet. 2000
Feb 12;355(9203):517-22.

"Homocysteine-lowering treatment with folic acid plus vitamin B6 in
healthy siblings of patients with premature atherothrombotic disease is
associated with a decreased occurrence of abnormal exercise
electrocardiography tests, which is consistent with a decreased risk of
atherosclerotic coronary events."

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10683000&dopt=Abstract

(4) Chambers JC et al, Improved vascular endothelial function after oral
B vitamins: An effect mediated through reduced concentrations of free
plasma homocysteine. Circulation. 2000 Nov 14;102(20):2479-83.

"Folic acid and vitamin B(12) supplementation improves vascular
endothelial function in patients with CHD, and this effect is likely to
be mediated through reduced concentrations of free plasma homocysteine
concentrations. Our data support the view that lowering homocysteine,
through B vitamin supplementation, may reduce cardiovascular risk."

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11076820&dopt=Abstract 

-- 
Juhana

Relevant Pages

  • Re: the business of carbs or is it the conspiracy or carbs?
    ... that have treated the high homocysteine have found that the treatment group ... supplementation reduced the risk of major cardiovascular events in patients ... and 1 mg of vitamin B12 or with placebo for an average of five years. ...
    (sci.med.nutrition)
  • Re: Red Meat NO GOOD, Veggies no protection.... NOW WHAT?
    ... Dietary pattern is associated with homocysteine and B vitamin status ... To identify existing dietary patterns and examine associations between ... The prevalence of high homocysteine (>11 micro mol/L ...
    (sci.med.cardiology)
  • Re: Red Meat NO GOOD, Veggies no protection.... NOW WHAT?
    ... Dietary pattern is associated with homocysteine and B vitamin status ... To identify existing dietary patterns and examine associations between ... The prevalence of high homocysteine (>11 micro mol/L ...
    (sci.med.nutrition)
  • Re: Red Meat NO GOOD, Veggies no protection.... NOW WHAT?
    ... Dietary pattern is associated with homocysteine and B vitamin status ... To identify existing dietary patterns and examine associations between ... The prevalence of high homocysteine (>11 micro mol/L ...
    (sci.med)