Homocysteine lowering interventions for peripheral arterial disease and bypass grafts

There is insufficient evidence of homocysteine lowering interventions on progression and outcomes for people with peripheral arterial disease (PAD) and hyperhomocysteinaemia.

The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding), by inconcistency (variability in results), and by imprecise results (few patients).

Summary

A Cochrane review included 2 studies with a total of 161 subjects. The studies did not report on mortality and rate of limb loss. One study (n=133) showed that there was a significant improvement in ankle brachial index (ABI) in participants who received folic acid compared with placebo (MD 0.07, 95% CI 0.04 to 0.11, P < 0.001) and in participants who received 5-methyltetrahydrofolate (5-MTHF) versus placebo (MD 0.05, 95% CI 0.01 to 0.10, P = 0.009). A second study (n=18) showed that there was no difference (P non-significant) in ABI in participants who received a multivitamin B supplement (mean ± SEM: 0.7 ± 01) compared with placebo (mean ± SEM: 0.8 ± 0.1). No major events were reported.

Ədəbiyyat

1. Andras A, Stansby G, Hansrani M. Homocysteine lowering interventions for peripheral arterial disease and bypass grafts. Cochrane Database Syst Rev 2013;(7):CD003285. .