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Volume 351:1259-1260 September 16, 2004 Number 12
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Folate Therapy and In-Stent Restenosis

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 by Lange, H.
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To the Editor: Lange et al. (June 24 issue)1 report an increase in the relative risk of restenosis after bare-metal stenting in patients receiving B vitamins to lower homocysteine levels. This seems to be in contrast to a previous report of a dramatic reduction in restenosis with the use of homocysteine-lowering B-vitamin treatment after coronary angioplasty.2 These two studies differ substantially (e.g., with respect to the vitamin dose, lesion length, and percutaneous coronary intervention procedures investigated). Mechanisms of restenosis in swine in response to arterial injury differ substantially between angioplasty and stenting.3 Homocysteine stimulates the proliferation of vascular smooth-muscle cells, . . . [Full Text of this Article]




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