Low-dose folic acid supplementation reduces homocysteine concentration in hyperhomocysteinemic coronary artery disease patients

Whether patients with coronary artery disease need to supplement their diet with a high dose of folic acid (even if their folate status is adequate) to reduce their plasma homocysteine concentration remains unclear. The purpose of this study was to evaluate the effect of a low oral dose of folic acid on lowering the plasma homocysteine concentration in response to the 5,10-methylenetetrahydrofolate reductase 677→T genotypes in patients with coronary artery disease. Patients were randomly assigned to 1 of 2 groups: a placebo group (n = 22; CC/CT/TT = 12/7/3) and a folic acid group (400 μg/d folate; n = 24; CC/CT/TT = 8/11/5). Intervention was administered for 2 months (8 weeks). Folic acid supplements did not significantly lower fasting plasma homocysteine concentration after 8 weeks of supplementation. However, low-dose folic acid supplementation (400 μg/d) significantly reduced homocysteine by 1.8 μmol/L (P < .05) at week 8 for those subjects with hyperhomocysteinemia, especially for carriers of the T-allele.