An extra dose of folic acid and B vitamins might be a cheap and safe way to prevent more problems for many heart patients. A new study shows the supplements reduce the risk of death, heart attack, or repeat surgery in people who recently had a balloon angioplasty to open a clogged artery.

The study appears in the Aug. 28 issue of The Journal of the American Medical Association.

Angioplasty involves expanding and slightly damaging the artery walls with a balloon to clear blockages. Some patients may develop repeat blockages if their body produces too much scar tissue following the procedure. According to researchers, about 20% of balloon angioplasty patients suffer from this condition and must undergo another angioplasty to correct the problem.

Previous research has shown that heart patients with high levels of an amino acid called homocysteine in their blood are the most likely to suffer from complications such as artery blockage or heart attack after heart surgery. That prompted the researchers to look at whether using supplements of folic acid and vitamins B-6 and B-12, which are known to lower homocysteine levels, would reduce this risk.

They found that patients given the supplements for six months after a successful angioplasty were 32% less likely to have suffered complications such as another blockage, heart attack, or death up to a year later.

Homocysteine is considered by a lot of physicians to be a major risk factor for heart disease, similar to high cholesterol, diabetes, smoking, or high blood pressure, says study author Guido Schnyder, MD, assistant professor in the division of cardiology at the University of California, San Diego.

"What the vitamin treatment does is lower homocysteine levels by somewhere between 25 to 35 percent, so this is probably the mechanism from which benefit is obtained," Schnyder says

Until now, the only other treatment found to reduce the risk of repeat blockages in angioplasty patients was expensive, medication-coated stents or supports to keep arteries open.

"This combination of something very inexpensive with almost no side effects is refreshing," says Schnyder.

Robert Bonow, MD, president of the American Heart Association, says if these findings are confirmed by larger studies, it could have an important impact on how patients are treated after heart surgery as well as how people with heart disease in general are treatedesearchers say that reduction in risk is most likely due to the homocysteine-lowering power of the vitamins.

Bonow says he already recommends that anyone concerned about reducing their risk of heart disease eat a diet naturally rich in the folic acid and B vitamins found in foods such as cereals and leafy green vegetables and take a multivitamin.

"What's interesting here [in this study], is that the vitamins were given in higher does than you would receive if you were taking a multivitamin," Bonow tells WebMD. "B vitamins allow you to metabolize homocysteine and break it down.

"But now the question is what's the effect of B vitamins here," says Bonow, who is also chief of cardiology and professor of medicine at Northwestern University. "If they really are effective at preventing further [blockage] after angioplasty, is it because of the homocysteine effect, or is there a more direct effect of these vitamins on the blood vessel?"

Recent studies have found that other vitamins known as antioxidants (including vitamins A, C, and E), do not reduce the risk of heart disease. But B vitamins and folic acid work in completely different ways to promote heart health, Bonow and Schnyder point out. B vitamins and folic acid target homocysteine levels, while the antioxidants had been thought to affect how the body processes cholestero