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https://hdl.handle.net/2440/34698
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Type: | Journal article |
Title: | Effect of vitamins C and E on progression of transplant-associated arteriosclerosis: a randomised trial. |
Author: | Fang, J. Kinlay, S. Beltrame, J. Hikiti, H. Wainstein, M. Behrendt, D. Suh, J. Frei, B. Mudge, G. Selwyn, A. |
Citation: | The Lancet, 2002; 359(9312):1108-1113 |
Publisher: | Lancet Ltd |
Issue Date: | 2002 |
ISSN: | 0140-6736 1474-547X |
Statement of Responsibility: | James C Fang, Scott Kinlay, John Beltrame, Hiroyuki Hikiti, Marco Wainstein, Dominik Behrendt, Jung Suh, Balz Frei, Gilbert H Mudge, Andrew P Selwyn, Peter Ganz |
Abstract: | Background: Cardiac transplantation is associated with oxidant stress, which may contribute to the development of accelerated coronary arteriosclerosis. We postulated that treatment with antioxidant vitamins C and E would retard the progression of transplant-associated arteriosclerosis. Methods: In a double-blind prospective study, 40 patients (0–2 years after cardiac transplantation) were randomly assigned vitamin C 500 mg plus vitamin E 400 IU, each twice daily (n=19), or placebo (n=21) for 1 year. The primary endpoint was the change in average intimal index (plaque area divided by vessel area) measured by intravascular ultrasonography (IVUS). Coronary endothelium-dependent vasoreactivity was assessed with intracoronary acetylcholine infusions. IVUS, coronary vasoreactivity, and vitamin C and E plasma concentrations were assessed at baseline and at 1 year follow-up. All patients received pravastatin. Analyses were by intention to treat. Findings: Vitamin C and E concentrations increased in the vitamin group (vitamin C 43 [SD 21] to 103 [43] μmol/L; vitamin E 24 [14] to 65 [27] μmol/L) but did not change in the placebo group (vitamin C 45 [15] vs 43 [16] μmol/L; vitamin E 27 [14] vs 27 [9] μmol/L; p<0•0001 for difference between groups). During 1 year of treatment, the intimal index increased in the placebo group by 8% (SE 2) but did not change significantly in the treatment group (0•8% [1]; p=0•008). Coronary endothelial function remained stable in both groups. Interpretation Supplementation with antioxidant vitamins C and E retards the early progression of transplant-associated coronary arteriosclerosis. |
Keywords: | Coronary Vessels Endothelium, Vascular Tunica Intima Humans Disease Progression Ascorbic Acid Vitamin E Antioxidants Ultrasonography, Interventional Drug Therapy, Combination Heart Transplantation Prospective Studies Double-Blind Method Vasodilation Middle Aged Female Male Coronary Artery Disease |
DOI: | 10.1016/S0140-6736(02)08154-0 |
Description (link): | http://www.elsevier.com/wps/find/journaldescription.cws_home/31066/description#description |
Published version: | http://dx.doi.org/10.1016/s0140-6736(02)08154-0 |
Appears in Collections: | Aurora harvest Medicine publications |
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