Platelet Count Affects Efficacy of Folic Acid in Preventing First Stroke

Journal of the American College of Cardiology
Xiangyi KongYong Huo

Abstract

The role of platelets and important effect modifiers on the risk of first stroke is unknown. This study examined whether low platelet count (PLT) and elevated total homocysteine (tHcy) levels jointly increase the risk of first stroke, and, if so, whether folic acid treatment is particularly effective in stroke prevention in such a setting. A total of 10,789 Chinese hypertensive adults (mean age 59.5 years; 38% male, with no history of stroke and myocardial infarction) were analyzed from the China Stroke Primary Prevention Trial, where participants were randomly assigned to daily treatments of 10 mg enalapril and 0.8 mg folic acid (n = 5,408) or 10 mg enalapril alone (n = 5,381). The primary endpoint was first stroke. During 4.2 years of follow-up, a total of 371 first strokes occurred. In the enalapril-alone group, the lowest rate of first stroke (3.3%) was found in patients with high PLT (quartiles 2 to 4) and low tHcy (<15 μmol/l); and the highest rate (5.6%) was in patients with low PLT (quartile 1) and high tHcy (≥15 μmol/l) levels. Following folic acid treatment, the high-risk group had a 73% reduction in stroke (hazard ratio: 0.27; 95% confidence interval: 0.11 to 0.64; p = 0.003), whereas there was no significant effect ...Continue Reading

Associated Clinical Trials

Citations

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Dec 30, 2020·Phytomedicine : International Journal of Phytotherapy and Phytopharmacology·Xin-Yu JiYong-Yan Wang
Nov 21, 2020·Antioxidants·Kassidy BurgessNafisa M Jadavji
Jan 30, 2021·Journal of the American College of Cardiology·David J A JenkinsJohn L Sievenpiper
Mar 17, 2021·Critical Reviews in Food Science and Nutrition·Geir BjørklundBeatrice Severin
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Sep 9, 2021·International Journal of Clinical Practice·Refik Kunt, Onur Yiğitaslan
Oct 15, 2021·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Panpan HeMin Liang

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