Comment 
Share 
Cite
Print
Text size
A 42-month follow-up of the 593 stable CAD patients randomized to either 0.5-mg/day folic acid or no folate supplementation in an open-label fashion showed no difference in survival between the two groups (p=0.53).
Previous studies have demonstrated that folate status is linked to homocysteine and that supplementation with folic acid can reduce plasma homocysteine levels. However, the Goes study is the most recent of a number of trials that suggest that high homocysteine may not be as robust a risk factor for CVD as first believed.
Treat folic acid with reservation until more data available
Folic acid supplementation should be treated with reservation until more trials become available.
Repeating what he and colleagues said in their paper, Liem said folic acid did not seem to reduce the end points in the study and that homocysteine appears to be "only a modifiable marker of disease, which we can lower with folic acid, but this does not necessarily reduce risk in these patients."
"Folic acid supplementation should be treated with reservation until more trials become available," Liem commented.
The chair of the session, Dr Jaakko Tuomilehto (University of Helsinki, Finland), commented that perhaps the best use of homocysteine "would be to scare our patients into stopping smoking."
