Positive Health Online

Abstract

FANG and colleagues, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA 02115, USA, jfang@partners.org, investigated whether dietary supplementation with antioxidant vitamins (C and E) might slow the progression of cardiac transplant-associated arteriosclerosis.

Background

Oxidative stress occurs during cardiac transplantation and may contribute to the progression of coronary atherosclerosis.

Methodology

This was a double-blind, randomized, placebo-controlled, prospective clinical trial carried out in 40 patients at zero to 2 years after cardiac transplantation. Patients received 1) 500 mg vitamin C + 400 IU vitamin E twice daily (n=19) or 2) placebo (n=21) for 12 months. All patients also received the cholesterol-lowering drug pravastatin. Patients were assessed at baseline and 12 months for: change in average intimal index (plaque area divided by vessel area), measured by intravascular ultrasonography (IVUS); coronary endothelium-dependent vasoreactivity, assessed by intracoronary infusion of acetylcholine; and plasma levels of vitamins C and E. Results were analysed on an intent-to-treat basis.

Results

In the vitamin-supplemented group, plasma levels of vitamins C and E increased significantly from baseline to 12 months, whereas plasma vitamin levels remained unchanged in the placebo group. In the vitamin-supplemented group, the intimal index did not change significantly from baseline to 12 months; however, this index increased by 82% in the placebo group. No changes in measures of coronary endothelial function were observed in either treatment group.

Conclusion

The findings indicate that dietary supplementation with antioxidant vitamins (C and E) can slow early progression of arteriosclerosis associated with cardiac transplantation.

References

Fang JC et al. Effect of vitamins C and E on progression of transplant-associated arteriosclerosis: a randomised trial. Lancet 359 (9312): 1108-13. Mar 2002.