Folate Intervention in Non-ST elevation myocardial infarction and unstable angina: a randomised placebo-controlled trial

ISRCTN ISRCTN30249553
DOI https://doi.org/10.1186/ISRCTN30249553
Secondary identifying numbers N/A
Submission date
26/06/2007
Registration date
30/07/2007
Last edited
06/07/2009
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Jose Jr Nevado
Scientific

1148 Orani Street
Malinta
Valenzuela City
1440
Philippines

Phone +63 (0)2 4433711
Email jolnev2000@yahoo.com

Study information

Study designThe study is a randomised placebo-controlled trial. The participants are recruited from five medical centres. The participants, researchers and assessors were blinded to treatment assignment.
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Scientific title
Study acronymFINEST
Study objectivesHomocysteine is a sulphur-containing amino acid derived from the demethylation of methionine. Increased plasma homocysteine level has been recognised as a risk factor for cardiovascular diseases. Non-ST Elevation Myocardial Infarction (NSTEMI) and Unstable Angina (UA) belong to the spectrum of Acute Coronary Syndromes (ACS) that implies partial occlusion of the coronaries leading to ischaemic events. Unstable angina and NSTEMI have high recurrence rates for ACS and mortality six months after the event. Blood homocysteine levels are higher in patients with unstable angina, and it has been implicated to poorer outcomes and greater myocardial injury. Low homocysteine level confers better long-term outcomes among patients with coronary heart disease.

Folic acid is a potent homocysteine-lowering agent. It is used in several clinical trials to assess reduction of outcomes in subjects with cardiovascular disease.

Hypothesis:
Homocysteine-lowering could reduce subsequent clinical events, such as mortality and the composite outcomes of mortality, nonfatal acute coronary syndrome and other serious re-hospitalisation in people with UA or NSTEMI.
Ethics approval(s)Committee on Research Implementation and Development (CRID) (presently Research Implementation and Development Office [RIDO]) of the College of Medicine, University of the Philippines Manila, approved on October 25, 2002.
Health condition(s) or problem(s) studiedAcute Coronary Syndromes (ACS)
InterventionActive group (116 participants): A once daily oral supplement of 1 mg folic acid, 400 µg vitamin B12, and 10 mg vitamin B6 for six months
Placebo group (124 participants): Once daily oral placebo supplement for six months

The participants were followed up for six months.
Intervention typeSupplement
Primary outcome measure1. All-cause mortality
2. Composite outcomes of mortality, nonfatal acute coronary syndromes and serious rehospitalisation

Outcomes measured every six months for three years, timepoints were as follows:
31st January 2004
31st July 2004
31st January 2005
31st July 2005
31st January 2006
31st July 2006
Secondary outcome measuresNo secondary outcome measures
Overall study start date15/08/2003
Completion date15/08/2006

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants250
Key inclusion criteriaSubjects with unstable angina (intermediate- and high-risk) or NSTEMI with an onset in the past two weeks were screened for inclusion for the study. Participants should be more than 18 years of age upon inclusion, either male or female.
Key exclusion criteriaThe exclusion criteria include the following:
1. Haemodynamic instability (cardiogenic shock, ongoing chest pain, unresolved and new onset end-organ damage, and unstable congestive heart failure in the past two weeks)
2. Significant liver disease (classical signs and symptoms, or three times the upper limit of normal in liver enzymes, or a deranged Prothrombin Time [PT] 1.5 x normal not explained by anticoagulant intake)
3. Significant renal disease (with creatinine levels more than 180 µmol/dl or requiring dialysis)
4. Haemoglobin less than 1 g/dl
5. High output failure
6. Could not provide adequate self-care
7. Malignancy or any terminal illness
8. Pregnancy
10. Could not provide independent informed consent
11. Living outside Metro Manila or the adjacent provinces of Cavite and Rizal
Date of first enrolment15/08/2003
Date of final enrolment15/08/2006

Locations

Countries of recruitment

  • Philippines

Study participating centre

1148 Orani Street
Valenzuela City
1440
Philippines

Sponsor information

Philippine Council for Health Research and Development (PCHRD) (Philippines)
Government

3rd Floor
Department of Science and Technology (DOST)
Main Building
General Santos Avenue
Bicutan
Taguig City
1631
Philippines

Phone +63 (0)2 8377535
Email gigi@pchrd.dost.gov.ph
Website http://www.pchrd.dost.gov.ph

Funders

Funder type

Government

The Department of Science and Technology (Philippines) - Grants in Aid program (DOST-GIA)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/01/2009 Yes No