Homocysteine - A treatable risk factor for allograft vascular disease after heart transplantation?

Growing evidence suggests that elevated total plasma homocysteine (tHCY) le vels are associated with cardiac allograft vasculopathy following heart tra nsplantation. To assess the effect of folic acid supplementation on tHCY le vels, we performed a prospective study in a cohort of 69 patients (7.0 +/- 3.2 years after heart transplantation; mean age, 55.0 +/- 9.6 years; 61 mal e) treated with 5 mg folic acid/day (n = 34) vs no medication (n = 35). The rapy with folic acid resulted in significantly decreased tHCY levels, from 22.6 +/- 9.6 mu mol/liter to 17.3 +/- 5.5 mu mol/liter (p = 0.001) within 3 months, whereas values in the control group remained unchanged. We conclud e that folic acid supplementation (5 mg per day) provides a simple and effe ctive measure to lower elevated tHCY levels in heart transplant recipients.