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Serum folate and homocysteine and the incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study.
Am J Clin Nutr 2004; 80(2):317-23AJ

Abstract

BACKGROUND

Several, but not all, prospective studies have shown that low folate intakes, low circulating folate concentrations, or high plasma total homocysteine (tHcy) concentrations are associated with an increased risk of coronary artery disease (CAD).

OBJECTIVE

We examined the relations of both serum folate and serum tHcy concentrations with acute coronary events in middle-aged men from eastern Finland who had no CAD at baseline.

DESIGN

In a population-based prospective cohort study, 1027 men aged 46-64 y were examined in 1991-1993 as part of the Kuopio Ischaemic Heart Disease Risk Factor Study. During an average follow-up of 7.7 y (7900 person-years of follow-up), 114 acute coronary events were observed in 61 men who had no previous history of CAD (n = 810).

RESULTS

In a Cox model, compared with men whose serum folate concentrations were in the lowest tertile, those whose concentrations were in the highest tertile had a risk factor-adjusted relative risk of acute coronary events of 0.35 (95% CI: 0.17, 0.73; P = 0.005). Serum tHcy concentrations were not significantly associated with the risk of acute coronary events (for the highest tertile compared with the lowest, adjusted relative risk = 1.03; 95% CI: 0.57, 1.87; P = 0.932).

CONCLUSIONS

The results of this prospective cohort study do not support the hypothesis that a high circulating tHcy concentration is a risk factor for acute coronary events in a male population free of prior heart disease. However, they do suggest that moderate-to-high serum folate concentrations are associated with a greatly reduced incidence of acute coronary events.

Authors+Show Affiliations

Research Institute of Public Health, University of Kuopio, PO Box 1627, 70211 Kuopio, Finland. sari.voutilainen@uku.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15277151

Citation

Voutilainen, Sari, et al. "Serum Folate and Homocysteine and the Incidence of Acute Coronary Events: the Kuopio Ischaemic Heart Disease Risk Factor Study." The American Journal of Clinical Nutrition, vol. 80, no. 2, 2004, pp. 317-23.
Voutilainen S, Virtanen JK, Rissanen TH, et al. Serum folate and homocysteine and the incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2004;80(2):317-23.
Voutilainen, S., Virtanen, J. K., Rissanen, T. H., Alfthan, G., Laukkanen, J., Nyyssönen, K., ... Salonen, J. T. (2004). Serum folate and homocysteine and the incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. The American Journal of Clinical Nutrition, 80(2), pp. 317-23.
Voutilainen S, et al. Serum Folate and Homocysteine and the Incidence of Acute Coronary Events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2004;80(2):317-23. PubMed PMID: 15277151.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum folate and homocysteine and the incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. AU - Voutilainen,Sari, AU - Virtanen,Jyrki K, AU - Rissanen,Tiina H, AU - Alfthan,Georg, AU - Laukkanen,Jari, AU - Nyyssönen,Kristiina, AU - Mursu,Jaakko, AU - Valkonen,Veli-Pekka, AU - Tuomainen,Tomi-Pekka, AU - Kaplan,George A, AU - Salonen,Jukka T, PY - 2004/7/28/pubmed PY - 2004/9/1/medline PY - 2004/7/28/entrez SP - 317 EP - 23 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 80 IS - 2 N2 - BACKGROUND: Several, but not all, prospective studies have shown that low folate intakes, low circulating folate concentrations, or high plasma total homocysteine (tHcy) concentrations are associated with an increased risk of coronary artery disease (CAD). OBJECTIVE: We examined the relations of both serum folate and serum tHcy concentrations with acute coronary events in middle-aged men from eastern Finland who had no CAD at baseline. DESIGN: In a population-based prospective cohort study, 1027 men aged 46-64 y were examined in 1991-1993 as part of the Kuopio Ischaemic Heart Disease Risk Factor Study. During an average follow-up of 7.7 y (7900 person-years of follow-up), 114 acute coronary events were observed in 61 men who had no previous history of CAD (n = 810). RESULTS: In a Cox model, compared with men whose serum folate concentrations were in the lowest tertile, those whose concentrations were in the highest tertile had a risk factor-adjusted relative risk of acute coronary events of 0.35 (95% CI: 0.17, 0.73; P = 0.005). Serum tHcy concentrations were not significantly associated with the risk of acute coronary events (for the highest tertile compared with the lowest, adjusted relative risk = 1.03; 95% CI: 0.57, 1.87; P = 0.932). CONCLUSIONS: The results of this prospective cohort study do not support the hypothesis that a high circulating tHcy concentration is a risk factor for acute coronary events in a male population free of prior heart disease. However, they do suggest that moderate-to-high serum folate concentrations are associated with a greatly reduced incidence of acute coronary events. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/15277151/Serum_folate_and_homocysteine_and_the_incidence_of_acute_coronary_events:_the_Kuopio_Ischaemic_Heart_Disease_Risk_Factor_Study_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/80.2.317 DB - PRIME DP - Unbound Medicine ER -