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Secondary prevention with folic acid: results of the Goes extension study
  1. A Liem1,
  2. G H Reynierse-Buitenwerf1,
  3. A H Zwinderman2,
  4. J W Jukema3,
  5. D J van Veldhuisen4
  1. 1Department of Cardiology, Oosterscheldeziekenhuizen, Goes, the Netherlands
  2. 2Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
  3. 3Leiden University Medical Centre, Leiden, the Netherlands
  4. 4University Hospital, Groningen, the Netherlands
  1. Correspondence to:
    Dr A Liem
    Department of Cardiology, Oosterscheldeziekenhuizen, Post-box 106, 4460BB Goes, Netherlands;

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Homocysteine has been regarded as a modest independent risk factor for atherosclerotic vascular disease.1,2 Although folic acid can reduce homocysteine concentrations substantially, the value of folic acid intervention in primary and secondary prevention in terms of hard clinical end points is still uncertain. Many studies addressing this question are still underway. The results on folic acid intervention in patients undergoing percutaneous coronary intervention are not consistent.3 Recently we have reported the results of an open label intervention study with folic acid in a population with stable coronary artery disease while taking stable statin treatment.4 Within a follow up of 24 (10) months folic acid did not appear to attenuate the risk for recurrent events. Yet longer follow up observations are necessary before definite conclusions can be made. We therefore continued the study after renewed informed consent of the participating patients. We report here the results of the study with a mean (SD) follow up of 42 (10) months. In addition, we analysed the data again according to contemporary definitions of acute coronary syndromes (ACS).5


The methods of the study have been previously reported.4 Briefly, consecutive patients with stable coronary artery disease visiting the outpatient department of the cardiology department were screened for inclusion. The history of patients had to include one of …

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