PMID- 16634837
OWN - NLM
STAT- MEDLINE
DCOM- 20060915
LR  - 20151119
IS  - 0014-2972 (Print)
IS  - 0014-2972 (Linking)
VI  - 36
IP  - 5
DP  - 2006 May
TI  - No effect of homocysteine-lowering therapy on vascular inflammation and 
      haemostasis in peripheral arterial occlusive disease.
PG  - 333-9
AB  - BACKGROUND: Although peripheral arterial occlusive disease (PAOD) is 
      significantly associated with elevated homocysteine levels, the clinical 
      relevance of hyperhomocysteinaemia for the prevention and progression of PAOD is 
      still unknown. MATERIALS AND METHODS: A total of 65 patients suffering from 
      symptomatic PAOD with elevated homocysteine levels were randomized onto placebo 
      or B-vitamins (50 mg thiaminhydrochlorid, 50 mg pyridoxine, and 0.05 mg 
      cyanocobalamin), plus 5 mg folic acid daily for 6 weeks. Serum levels of folic 
      acid, vitamin B12, creatinine, ultra-sensitive C-reactive protein (usCRP), 
      interleukin (IL)-6, IL-8, IL-18, monocyte-chemo-attractant-protein-1 (MCP-1) and 
      plasma levels of homocysteine, tissue factor (TF) and tissue factor pathway 
      inhibitor (TFPI) were determined on the 1st day and 42nd day. Primary outcome was 
      reduction of homocysteine, secondary outcomes were reduction of usCRP, IL-6, 
      IL-8, Il-18, MCP-1, TF and TFPI. RESULTS: The mean reduction of homocysteine 
      concentration was 33% (95%CI 33.36-55.76, or 18.9+/-5.4 micromol L-1-12.6+/-2.8 
      micromol L-1, P=0) in the B-vitamin group compared with 1% in the placebo group. 
      Folic acid (P=0) and vitamin B12 (P=0) increased significantly in the verum 
      group, but both remained unchanged in the control group. No treatment effect of 
      lowering of homocysteine on any markers of haemostasis (TF, TFPI) or inflammation 
      (usCRP, IL-6, IL-8, IL-18 and MCP-1) was observed. CONCLUSION: Although 
      homocysteine is associated with vascular disease risk in the general population 
      and in particular with PAOD, marked lowering of homocysteine concentrations by 
      folic acid and B-vitamin supplementation does not influence inflammatory 
      responses involving usCRP, IL-6, IL-8, IL-18 and MCP-1, nor tissue factor. These 
      results provide evidence against a major effect of hyperhomocysteinaemia on 
      vascular chronic inflammation or coagulation in patients with symptomatic 
      peripheral arterial occlusive disease.
FAU - Schernthaner, G-H
AU  - Schernthaner GH
AD  - Department of Internal Medicine II, Medical University of Vienna, and Department 
      of Internal Medicine I, Rudolfstiftung Hospital, Vienna, Austria. 
      gerit.schernthaner@meduniwien.ac.at
FAU - Plank, C
AU  - Plank C
FAU - Minar, E
AU  - Minar E
FAU - Bieglmayer, C
AU  - Bieglmayer C
FAU - Koppensteiner, R
AU  - Koppensteiner R
FAU - Schernthaner, G
AU  - Schernthaner G
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - England
TA  - Eur J Clin Invest
JT  - European journal of clinical investigation
JID - 0245331
RN  - 0 (Biomarkers)
RN  - 0 (Inflammation Mediators)
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - 12001-76-2 (Vitamin B Complex)
RN  - 935E97BOY8 (Folic Acid)
SB  - IM
MH  - Aged
MH  - Arterial Occlusive Diseases/blood/*etiology
MH  - Biomarkers/blood
MH  - Chronic Disease
MH  - Drug Therapy, Combination
MH  - Female
MH  - Folic Acid/therapeutic use
MH  - Hemostasis/drug effects
MH  - Homocysteine/blood
MH  - Humans
MH  - Hyperhomocysteinemia/complications/*drug therapy
MH  - Inflammation Mediators/blood
MH  - Male
MH  - Middle Aged
MH  - Patient Compliance
MH  - Peripheral Vascular Diseases/blood/*etiology
MH  - Vasculitis/blood/*drug therapy/etiology
MH  - Vitamin B Complex/therapeutic use
EDAT- 2006/04/26 09:00
MHDA- 2006/09/16 09:00
CRDT- 2006/04/26 09:00
PHST- 2006/04/26 09:00 [pubmed]
PHST- 2006/09/16 09:00 [medline]
PHST- 2006/04/26 09:00 [entrez]
AID - ECI1639 [pii]
AID - 10.1111/j.1365-2362.2006.01639.x [doi]
PST - ppublish
SO  - Eur J Clin Invest. 2006 May;36(5):333-9. doi: 10.1111/j.1365-2362.2006.01639.x.