Here's something recent on this:http://www.ajcn.org/misc/release1.shtml#voutilainen

Serum Homocysteine or Folate Levels and Heart Disease Risk


Many, but not all, prior studies found an association of high serum homocysteine level with an increased risk of coronary heart disease (CHD). Since low folate levels are also associated with high serum homocysteine, CHD risk could be regulated by folate instead of by homocysteine levels. Publishing in this month’s American Journal of Clinical Nutrition, Dr. Voutilainen and colleagues in Finland evaluated these relationships in a prospective study of 810 men aged 46 to 64 years of age. During a 7.7 year follow-up, an acute coronary event was recorded in 61 members of the group. The risk of an acute coronary event in those in the highest third of the serum folate values was 0.35 or 65% less than the risk in those whose serum folate values were in the lowest third, and there was no relationship of coronary risk to the initial serum homocysteine level. The authors concluded that high homocysteine did not influence acute CHD risk, but that high folate levels are protective against acute CHD. In an accompanying editorial, Dr. Refsum points to a 2002 meta-analysis of 5,072 acute coronary events that showed only a moderate relationship to serum homocysteine and that most studies of CHD risk have dealt with patients whose serum homocysteine levels were greater than those described in the present article. Published articles on possible folic acid prevention of CHD have thus far shown conflicting results, and the jury is still out on whether folic acid supplementation should be recommended for CHD prevention.


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;80:317-23. [Abstract] [PDF]


Refsum H. Is folic acid the answer? Am J Clin Nutr 2004;80:241-42.[PDF]