Impact of Longitudinal Changes in Metabolic Syndrome Status over 2 Years on 10-Year Incident Diabetes Mellitus

BACKGROUND: Metabolic syndrome (MetS) is a known predictor of diabetes mellitus (DM), but whether longitudinal changes in MetS status modify the risk for DM remains unclear. We investigated whether changes in MetS status over 2 years modify the 10-year risk of incident DM. METHODS: We analyzed data from 7,317 participants aged 40 to 70 years without DM at baseline, who took part in 2001 to 2011 Korean Genome Epidemiology Study. Subjects were categorized into four groups based on repeated longitudinal assessment of MetS status over 2 years: non-MetS, resolved MetS, incident MetS, and persistent MetS. The hazard ratio (HR) of new-onset DM during 10 years was calculated in each group using Cox models. RESULTS: During the 10-year follow-up, 1,099 participants (15.0%) developed DM. Compared to the non-MetS group, the fully adjusted HRs for new-onset DM were 1.28 (95% confidence interval [CI], 0.92 to 1.79) in the resolved MetS group, 1.75 (95% CI, 1.30 to 2.37) in the incident MetS group, and 1.98 (95% CI, 1.50 to 2.61) in the persistent MetS group (P for trend <0.001). The risk of DM in subjects with resolved MetS was significantly attenuated compared to those with persistent MetS over 2 years. In addition, the adjusted HR for 10-year developing DM gradually increased as the number of MetS components increased 2 years later. CONCLUSION: We found that discrete longitudinal changes pattern in MetS status over 2 years associated with 10-year risk of DM. These findings suggest that monitoring change of MetS status and controlling it in individuals may be important for risk prediction of DM.

Combining Potent Statin Therapy with Other Drugs to Optimize Simultaneous Cardiovascular and Metabolic Benefits while Minimizing Adverse Events

Hypercholesterolemia and hypertension are among the most important risk factors for cardiovascular (CV) disease. They are also important contributors to metabolic diseases including diabetes that further increase CV risk. Updated guidelines emphasize targeted reduction of overall CV risks but do not explicitly incorporate potential adverse metabolic outcomes that also influence CV health. Hypercholesterolemia and hypertension have synergistic deleterious effects on interrelated insulin resistance and endothelial dysfunction. Dysregulation of the renin-angiotensin system is an important pathophysiological mechanism linking insulin resistance and endothelial dysfunction to atherogenesis. Statins are the reference standard treatment to prevent CV disease in patients with hypercholesterolemia. Statins work best for secondary CV prevention. Unfortunately, most statin therapies dose-dependently cause insulin resistance, increase new onset diabetes risk and exacerbate existing type 2 diabetes mellitus. Pravastatin is often too weak to achieve target low-density lipoprotein cholesterol levels despite having beneficial metabolic actions. Renin-angiotensin system inhibitors improve both endothelial dysfunction and insulin resistance in addition to controlling blood pressure. In this regard, combined statin-based and renin-angiotensin system (RAS) inhibitor therapies demonstrate additive/synergistic beneficial effects on endothelial dysfunction, insulin resistance, and other metabolic parameters in addition to lowering both cholesterol levels and blood pressure. This combined therapy simultaneously reduces CV events when compared to either drug type used as monotherapy. This is mediated by both separate and interrelated mechanisms. Therefore, statin-based therapy combined with RAS inhibitors is important for developing optimal management strategies in patients with hypertension, hypercholesterolemia, diabetes, metabolic syndrome, or obesity. This combined therapy can help prevent or treat CV disease while minimizing adverse metabolic consequences.

Angiotensin converting enzyme inhibitors remain the first treatment of choice

No abstract available.

Hypertriglyceridemia and Cardiovascular Diseases: Revisited

Residual cardiovascular risk and failure of high density lipoprotein cholesterol raising treatment have refocused interest on targeting hypertriglyceridemia. Hypertriglyceridemia, triglyceride-rich lipoproteins, and remnant cholesterol have demonstrated to be important risk factors for cardiovascular disease; this has been demonstrated in experimental, genetic, and epidemiological studies. Fibrates can reduce cardiovascular event rates with or without statins. High dose omega-3 fatty acids continue to be evaluated and new specialized targeting treatment modulating triglyceride pathways, such as inhibition of apolipoprotein C-III and angiopoietin-like proteins, are being tested with regard to their effects on lipid profiles and cardiovascular outcomes. In this review, we will discuss the role of hypertriglyceridemia, triglyceride-rich lipoproteins and remnant cholesterol on cardiovascular disease, and the potential implications for treatment stargeting hypertriglyceridemia.

Additive Beneficial Effects of Valsartan Combined with Rosuvastatin in the Treatment of Hypercholesterolemic Hypertensive Patients

BACKGROUND AND OBJECTIVES: We compared the efficacy and safety of valsartan and rosuvastatin combination therapy with each treatment alone in hypercholesterolemic hypertensive patients. SUBJECTS AND METHODS: Patients who met inclusion criteria were randomized to receive 1 of the following 2-month drug regimens: valsartan 160 mg plus rosuvastatin 20 mg, valsartan 160 mg plus placebo, or rosuvastatin 20 mg plus placebo. The primary efficacy variables were change in sitting diastolic blood pressure (sitDBP) and sitting systolic blood pressure (sitSBP), and percentage change in low-density lipoprotein-cholesterol (LDL-C) in the combination, valsartan, and rosuvastatin groups. Adverse events (AEs) during the study were analyzed. RESULTS: A total of 354 patients were screened and 123 of them were finally randomized. Changes of sitDBP by least squares mean (LSM) were -11.1, -7.2, and -3.6 mm Hg, respectively, and was greater in the combination, as compared to both valsartan (p=0.02) and rosuvastatin (p<0.001). Changes of sitSBP by LSM were -13.2, -10.8, and -4.9 mm Hg, and was greater in the combination, as compared to rosuvastatin (p=0.006) and not valsartan (p=0.42). Percentage changes of LDL-C by LSM were -52, -4, and -47% in each group, and was greater in the combination, as compared to valsartan (p<0.001), similar to rosuvastatin (p=0.16). Most AEs were mild and resolved by the end of the study. CONCLUSION: Combination treatment with valsartan and rosuvastatin exhibited an additive blood pressure-lowering effect with acceptable tolerability, as compared to valsartan monotherapy. Its lipid lowering effect was similar to rosuvatatin monotherapy.

Erratum to: Additive Beneficial Effects of Valsartan Combined with Rosuvastatin in the Treatment of Hypercholesterolemic Hypertensive Patients

In this article, on page 230, Fig. 2A needs to be corrected.

Repeated Aborted Sudden Cardiac Death with Long QT Syndrome in a Patient with Anomalous Origin of the Right Coronary Artery from the Left Coronary Cusp

A 15-year-old female with a prior history of aborted cardiac death and surgical correction of anomalous origin of the right coronary artery (RCA) presented with polymorphic ventricular tachycardia. Her electrocardiogram after defibrillation was suggestive of congenital long QT syndrome (LQTS). The patient was treated with a beta-blocker and remained free from ventricular arrhythmia during the follow-up of more than 6 months. Here, we present the case of a young female with repeated aborted cardiac death accompanied by anomalous origin of the RCA and congenital LQTS for the first time.

Residual Cardiovascular Risk Remains Despite of Statin Treatment: Importance of High-Density Lipoprotein Cholesterol / 대한내과학회지

Lowering low-density lipoprotein-cholesterol (LDL-C) is the primary target to prevent cardiovascular events in patients with dyslipidemia at high risk for cardiovascular disease. Many patients on statin therapy have initial or recurrent coronary heart disease events despite reductions in LDL-C. Indeed, 2/3 of patients on statin therapy suffer from residual risk. Low high-density lipoprotein-cholesterol (HDL-C) and high triglycerides levels are modifiable and important factors to resolve a residual risk. Especially, low serum levels of HDL-C (< 40 mg/dL for men, < 50 mg/dL for women) are highly prevalent and are recognized as an independent risk factor for cardiovascular morbidity (myocardial infarction, stroke, peripheral arterial disease, and restenosis after coronary stenting) and mortality. Thus, therapy focusing on raising HDL-C may be an important paradigm for treating and slowing progression of atherosclerosis, coronary heart disease, and co-morbid metabolic disorders. In this review, we discuss the importance of HDL-C based on experimental and large scaled clinical trials.

Inferior Sinus Venosus Type Atrial Septal Defect Initially Presenting Pulmonary Hypertension on Transthoracic Echocardiography

Inferior sinus venosus type atrial septal defect (ASD) is a rare congenital cardiac deformity that occurs between the inferior vena cava and right atrium. Inferior sinus venosus defect is difficult to diagnose through transthoracic echocardiography because of its location which is infero-posterior to the fossa ovalis. Increasing pulmonary arterial pressure and pulmonary vascular resistance in patients with sinus venosus defect usually occur earlier than other types of ASD. We report a case of 19-year-old man who presented exertional dyspnea due to inferior sinus venous type ASD with mild pulmonary hypertension. In this case, we found clues from slight diastolic flattening of interventricular septum and shortened acceleration time of right ventricular outflow tract on initial transthoracic echocardiography, leading right heart catheterization and transesophageal echocardiography to reveal this rare type of ASD.

The prognostic value of NT-proBNP, Troponin I, and hs-CRP in patients with acute coronary syndrome / 대한내과학회지

BACKGROUND/AIMS: Elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), troponin I, and high-sensitivity C-reactive protein (hs-CRP) are each associated with higher rates of death and recurrent myocardial ischemia in patients with acute coronary syndrome (ACS). We evaluated the prognostic value of NT-proBNP and a multi-marker risk approach with the simultaneous assessment of NT-proBNP, troponin I, and hs-CRP in patients with ACS. METHODS: We included 277 patients who were admitted for ACS between January and December 2006. We measured NT-proBNP, troponin I, and hs-CRP within 24 hours of the onset of symptoms. Patients were followed for a median of 559 days for cardiovascular events, including death, new myocardial infarction, heart failure, or rehospitalization for ACS. RESULTS: NT-proBNP was the most powerful predictor of clinical outcome among the biomarkers (HR 3.65, 95% CI 2.11-6.30), followed by the peak troponin I and hs-CRP (HR 2.08, 95% CI 1.12-3.87;HR 1.99, 95% CI 1.18-3.37, respectively), but not the baseline troponin I. A multi-marker risk approach with the simultaneous assessment of NT-proBNP, hs-CRP, and peak troponin I was significantly associated with cardiovascular events, especially the presence of three positive biomarkers (adjusted HR 4.20, 95% CI 1.39-12.67). CONCLUSIONS: NT-proBNP is the most powerful, independent predictor of clinical outcome among the cardiac biomarkers. Since the peak troponin I level provides more prognostic information than the baseline level, follow-up measurement of troponin I may be warranted for risk stratification. The multi-marker risk approach appears to have better prognostic performance than any marker in isolation.

Clinical Significance of Left Ventricular Torsional Parameters during Supine Bicycle Cardiopulmonary Exercise Echocardiography

BACKGROUND: Left ventricular (LV) torsion plays an important role in both LV systolic and diastolic function. Notwithstanding the fact that speckle tracking imaging echocardiography (STI) is a validated method to measure LV torsion, few data regarding the clinical significance of LV torsional parameters using STI on exercise capacity during exercise echocardiography were reported. METHODS: Fifty four participants completed the supine bicycle cardiopulmonary exercise echocardiography under a symptom-limited protocol. LV torsion was defined as the net difference between LV peak apical rotation, and basal rotation divided by LV diastolic longitudinal length. LV basal, and apical short-axis rotations at each stage were analyzed by STI. RESULTS: LV torsion measurement was feasible in 43/54 (80%) at peak exercise. The LV torsions were increased during exercise, and even until the recovery. Peak twisting, and untwisting velocities were significantly increased during exercise, but were decreased at recovery. As expected, baseline torsion was positively correlated with LV ejection fraction and baseline apical peak untwisting velocity has correlation with E/E' (r=0.50, p<0.01 and r=0.30, p<0.05, respectively). Interestingly, apical peak twisting velocity at peak exercise was significantly correlated with maximal O2 consumption and VO2 interval change (r=0.50, p<0.01 and r=0.33, p<0.05, respectively). CONCLUSION: It was feasible to measure LV torsion by STI at every step during exercise echocardiography, although the feasibility was relatively low at peak exercise. LV torsional parameters during exercise showed significant relations with exercise capacity as well as LV systolic and diastolic functions.

The Additive Beneficial Effects of Ramipril Combined with Candesartan in Hypertensive Patients on Insulin Resistance, Plasma Adiponectin

BACKGROUND AND OBJECTIVES: Ramipril and candesartan have decreased the incidence of new onset diabetes in large scale randomized clinical studies. Because ramipril and candesartan have distinct mechanisms of action in the renin angiotensin aldosterone system, we hypothesized that combination therapy would have additive beneficial metabolic effects in patients with hypertension. SUBJECTS AND METHODS: Thirty-four patients were given ramipril 10 mg and placebo, ramipril 10 mg and candesartan 16 mg, or candesartan 16 mg and placebo daily in a randomized, double-blind, placebo-controlled cross-over trial with three treatment arms and two washout periods (each being 2 months). RESULTS: Ramipril, combination therapy or candesartan significantly increased the plasma adiponectin levels relative to the baseline measurements by 17+/-6% (p=0.038), 25+/-5% (p<0.001), and 14+/-6% (p=0.016), respectively. Combination therapy significantly increased the plasma adiponectin levels more than either ramipril or candesartan alone (p=0.020 by ANOVA). Only combination therapy significantly increased the QUICKI level relative to the baseline measurements (p=0.002). There were no significant correlations between these changes of the metabolic parameters and reduction of the systolic blood pressure (-0.288< or =r< or =0.284) and reduction of the diastolic blood pressure (-0.282< or =r< or =0.190). On multivariate analysis, only the change of adiponectin levels was an independent predictor of the changes in the QUICKI levels (beta=1.549, p=0.040) following combination therapy. CONCLUSION: Ramipril in combination with candesartan increases the plasma adiponectin levels to a greater extent than monotherapy with either drug alone. Only combination therapy significantly improves insulin sensitivity relative to the baseline measurements. The only predictor for the improvement of insulin sensitivity is the increase of plasma adiponectin levels by combination therapy.

Thrombosuction Utilizing an Export Aspiration Catheter during Primary Percutaneous Coronary Intervention in Acute Myocardial nfarction

PURPOSE: Effective myocardial reperfusion after primary PCI for an AMI in lesions with a thrombus is limited by distal embolization and the slow/no reflow phenomenon. We evaluated the efficacy of a thrombus reduction technique using an export aspiration catheter for thrombosuction during primary PCI. MATERIALS AND METHODS: We analyzed 62 patients with AMIs who underwent primary PCI and had a thrombi burden during thrombosuction using an EAC (EAC group; n=31) or without thrombosuction (control group; n=31). RESULTS: Thrombosuction with an EAC was performed safely in all the patients in EAC group without any complications. After the PCI, restoration to a TIMI flow grade 3 was significantly more frequent in the EAC group (26/31 vs. 20/31, p < 0.05). However, the TIMI perfusion grade did not differ between the two groups. Further, the corrected TIMI frame counts were lower in the EAC group (23.9 ± 15.1 vs. 34.8 ± 22.5, p < 0.05). Although there was no statistical significance, a greater incidence of distal embolization was observed in the control group (16.1%, 5/31) as compared to the EAC group (0/31) (p= 0.056). However, the incidence of major adverse cardiac events at 1 and 6 months did not differ between the two groups. CONCLUSION: For AMIs, thrombosuction with an EAC before or during PCI is a safe and potentially effective method for restoration of the coronary flow.

Efficacy of Thrombosuction using the Export Aspiration Catheter before Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction

BACKGROUND AND OBJECTIVES: Effective myocardial reperfusion following primary percutaneous coronary intervention for AMI, in lesions with a thrombus, is limited by distal embolization and slow/no reflow phenomenon. We evaluated the safety and efficacy of a thrombus reduction technique, using the export aspiration catheter for thrombosuction prior to primary PCI for AMI. SUBJECTS AND METHODS: We analyzed 61 AMI patients who had a thrombus burden on angiography, after having undergone primary PCI, either with or without EAC (EAC group; n=31, 24 males, mean ages 54.7+/-11.8 years)(control group; n=31, 20 males, mean ages 65.5+/-12.2 years). After the primary PCI, the angiographic findings and clinical outcomes at 1 and 6 months were recorded. RESULTS: The procedural and angiographic success rates were 100 (31/31) and 93.5 (29/31), and 100 (31/31) and 87.1% (27/31), respectively. After PCI, the recovery rate to TIMI 3 flow was higher in the EAC than the control group (26/31 vs. 20/31, p<0.05), and the corrected TIMI frame count was less in the EAC than the control group (23.9+/-15.1 vs. 34.8+/-22.5, p<0.05). However, there were no different in the TIMI perfusion grade between the two groups. Although there was no statistical significance, distal embolization was more commonly observed in control (16.1%, 5/31) than the EAC group (0/31)(p=0.056). There were no differences in the incidences of MACE at 1 (0 vs. 7.7%, p=0.237) and 6 months (6.9 vs. 0%, p=0.500) between two groups. In the 31 patients who underwent successful thrombosuction, gross thrombi were obtained from 25 (80.6%). CONCLUSION: In AMI, the use of thrombosuction, with EAC prior to PCI, provides a simple, rapid and potentially effective method for removal of the thrombus burden and restoration of coronary flow.

The Effects of Platelet-Derived Growth Factor Inhibitor(Trapidil) on Intimal Hyperplasia Following Coronary Stenting: Assessed by Intravascular Ultrasound

BACKGROUND AND OBJECTIVES: Platelet-derived growth factor (PDGF) seems to be one of the most powerful factors associated with the proliferative process that occurs after percutaneous transluminal coronary angioplasty (PTCA), and leads to restenosis. Trapidil (Triazolopyrimidine), a potent inhibitor of PDGF, was shown to decrease restenosis after experimental balloon angioplasty. The aim of this study was to assess the effects of trapidil, on intimal hyperplasia, following coronary artery stenting, using volumetric intravascular ultrasound (IVUS) analysis. SUBJECTS AND METHODS: The patients were divided in 2 groups; Group I (n=14, age=53+/-8, male=11) received trapidil (600 mg) for 6 months, aspirin (200 mg) indefinitely and ticlopidine (250 mg) for 4 weeks, Group 2 (n=15, age=55+/-2, male=9) received aspirin (200mg) indefinitely and ticlopidine (500 mg) for 4 weeks, starting at least 3 days before the angioplasty. A serial IVUS study was performed post-stenting, with a 6 month follow up period. Both the stent (SA) and lumen areas (LA) were measured, and the stent (SV), lumen (LV) and intimal hyperplasia volumes (IHV) were calculated using Simpson's rule. RESULTS: The reference (RD), pre minimal luminal (MLD) and post minimal luminal diameters, as measured by quantitative coronary angiographic analysis (QCA), were not different between the two groups. Using serial IVUS measurements, SV and LV were not different between the two groups. Also, the IHV was not different between the two groups (51.9+/-26.1 and 61.3+/-25.3 mm3, respectively, p=NS). CONCLUSION: Trapidil failed to reduce intimal hyperplasia following coronary stenting compared with the controls.

Effects of Simvastatin Alone or Combined With Ramipril on Nitric Oxide Bioactivity and Inflammation Markers in Hypercholesterolemic Patients

BACKGROUND AND OBJECTIVES: Because the mechanisms of the biological effects of statin and antiotensin converting enzyme inhibitor therapies differ, the vascular responses to these therapies were studied in hypercholesterolemic patients. MATERIALS AND METHODS: Simvastatin, 20 mg, placebo or ramipril, 10 mg, were administered daily for 2 months, with a 2 month washout, to 32 hypercholesterolemic patients. This was a randomized, double-blind, placebo-controlled, crossover in design study. RESULTS: Simvastatin alone, or in combination with ramipril, significantly changed the lipoproteins, and improved the percentage of the flow-mediated dilator response to hyperemia by 46+/-48% and by 59+/-66%, respectively, relative to the baseline measurements (both p<0.001). The plasma malondialdehyde levels were reduced, relative to baseline measurements, by 6+/-57% (p=0.045) and 13+/-47% (p=0.045 and p<0.001, respectively) and plasma levels of monocyte chemoattractant protein-1 by 3+/-27% and by 9+/-16%, respectively (p=0.113 and p=0.001, respectively). The C-reactive protein were also reduced, relative to baseline measurements, by 17+/-75% and by 17+/-37%, respectively (p=0.003 and p=0.001, respectively). However, simvastatin combined with ramipril changed, to a greater extent, but was statistically insignificant, the percentage of the flow-mediated dilator response to hyperemia, and the plasma monocyte chemoattractant protein-1 levels, than simvastatin alone. CONCLUSION: Compared with simvastatin alone, the addition of ramipril improved the endothelial function to greater extent, but was statistically insignificant, in hypercholes-terolemic patients.

Evaluation of Sympathetic Reinnervation Using 123I-MIBG Scintigraphy in Cardiac Transplants

BACKGROUND AND OBJECTIVES: It is known that sympathetic reinnervation, following a heart transplantation, increases with time. 123I metaiodobenzylguanidine (123I-MIBG) is taken up by myocardial sympathetic neurons in a manner similar to norepinephrine (NE), and is used as an imaging agent. The purpose of this study was to evaluate cardiac sympathetic reinnervation, following an orthotopic heart transplantation, using 123I-MIBG scintigraphy. SUBJECTS AND METHODS: Twenty four 123I-MIBG images of the chest were taken in 15 patients (10 males, 5 females, mean age: 35+/-13 years), 1 to 48 (mean 10.8+/-11.9) months after a transplantation. Two healthy adults were studied as normal controls. The 123I-MIBG images were acquired at 15 minutes, and 4 and 24 hours, after an intravenous injection of 185 MBq 123I-MIBG. To quantitate the degree of myocardial uptake of the MIBG, the heart to mediastinal ratio (HMR) was measured. In nine patients, the 123I-MIBG scintigraphy was repeated one year later. RESULTS: The HMRs of the 4 and 24 hour images (1.26+/-0.23, 1.06+/-0.10, respectively) were lower than those of the 15 minute images (1.48+/-0.28). Twelve subjects, 1 to 12 months after the transplantation, showed no visible myocardial activities, but 12 subjects, 13 to 48 (28.6+/-12.8) months after the transplantation, showed visible myocardial 123I-MIBG uptakes (HMR: 1.65+/-0.21). The HMRs were high in normal controls (mean 2.84). One-year follow up scintigraphy showed increased HMRs compared with those taken immediately postoperatively (1.40+/-0.31 to 1.61+/-0.16, p<0.05). CONCLUSION: Partial sympathetic late reinnervation can occur one year after a transplantation.

Clinical Experience of Cutting Balloon Angioplasty for in Stent Restenosis

BACKGROUND AND OBJECTIVES: A cutting balloon (CB) is a balloon catheter with 3 or 4 metal blades on its surface used for making controlled endovascular surgical incisions and promising minimal intimal injury. Some reports suggest advantages of the use of CB in the treatment of in-stent restenosis (ISR). The purpose of this study was to report the clinical experience of the use of CB for ISR. SUBJECTS AND METHODS: 28 patients were enrolled in this study. Angiographic success (defined by 40% residual stenosis), in-hospital, 30 days and 6 months clinical outcomes were evaluated. RESULTS: Angiographic success was 92.9% (26/28). The number of inflations and maximal inflation pressure were 2.8+/-0.9 and 10.1+/-1.3 ATM, respectively. The balloon/artery (B/A) ratio was 1.1+/-0.2. There was a case of stent insertion for treating type D dissection and a case of rotational atherectomy for suboptimal result after CB angioplasty. 25 cases underwent analysis through 6 months of clinical follow-up. During the 6-month clinical follow-up, 4 cases of re-PTCA were documented, while MACE during in-hospital time and the subsequent 30 days was 0%. CONCLUSION: Our experience demonstrated that CB can be performed safely and effectively in coronary ISR. Further clinical and angiographic effectiveness are warranted in a large-scale clinical trial.

The Effects of Vitamin B6 and Folate on The Level of Plasma Homocysteine and Brachial Artery Dilation in Healthy Subjects

BACKGROUND: Elevation in plasma homocysteine has been widely studied as an independent risk factor for atherosclerosis. And epidemiologic studies have demonstrated that the persons who take the folate and vitamin B6 have lower incidence of atherosclerotic vascular disease and lower plasma homocysteine level. But, not yet the effects of vitamin B6 and folate on the level of plasma homocysteine and brachial artery dilation on healthy subjects was not evaluated. METHODS: We evaluated the effects of 50 mg of vitamin B6 and 1 mg of folate on endothelial function, plasma homocysteine levels to one healthy postmenoausal woman and nineteen men in a randomized, double-blind, placebo-controlled, crossover design. RESULTS: In our study, supplement of vitamin B6 and folate significantly lowered plasma homocysteine level (placebo : folate =6.56 +1.55 micromol/L vs. 5.37 +1.04 micromol/L, p=.001). But, there were no statistically significant increament of flow-mediated dilation (FMD) compared to placebo (placebo : folate =5.12 +3.26% vs. 6.69 +2.60%, p=.070) and there were no significant correlation between the improvement of homocysteine level and increament of flow mediated dilation on healthy subjects. CONCLUSION: Compared to persons with absolute or relative hyper-homocysteinemia, our study did not show such favorable effects in healthy persons. So further studies must to be held to discover the effect of folate and vitamine B6 in healthy persons.

Can the endothelial dysfunction be reversed with medication? / 대한내과학회지

No abstract availalbe.