Clinical studyEffect of folic acid fortification of food on homocysteine-related mortality☆
Section snippets
Study sample
The study sample consisted of 2481 patients selected from the cardiac catheterization laboratory registry of the Intermountain Heart Collaborative Study (13). Patients had to have undergone angiography, have one or more ≥70% stenotic lesions, and have provided written consent to a blood draw at the time of angiography for use in confidential research studies approved by the LDS Hospital Institutional Review Board. Each patient had a minimum of 2 years of clinical follow-up. (The study sample
Results
Patients in the pre- and postfortification groups generally had similar characteristics (Table 1). The mean (± SD) age was 65 ± 11 years, and 77% were men. However, the postfortification cohort more often had a history of hypertension and hyperlipidemia, and a positive family history of coronary artery disease, but a slightly smaller proportion had three-vessel coronary disease. Patients enrolled after the 1998 mandate were also more likely to undergo percutaneous coronary intervention, but
Discussion
We found that after implementation of an FDA-mandated rule requiring fortification of food products with folic acid, there was a redistribution within homocysteine risk categories in a cohort of nearly 2500 patients with coronary artery disease. This was associated with a modest overall reduction in median homocysteine levels in the postfortification cohort. Generally, the relation of homocysteine to mortality risk was unchanged by fortification, although an improving survival trend was
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This study was supported by a grant from the Deseret Foundation, Salt Lake City, Utah, and an in-kind grant from Abbott Diagnostics, Abbott Park, Illinois.