Impact of vitamin E and C supplementation on serum adhesion molecules in chronic degenerative aortic stenosis: a randomized controlled trial

Am Heart J. 2005 Aug;150(2):302-6. doi: 10.1016/j.ahj.2004.09.009.

Abstract

Background: An inflammatory component has been identified in degenerative aortic stenosis (AS). The combination of vitamins E and C has been shown to have anti-inflammatory properties. The aim of this study was to determine the impact of the combination of vitamins C and E or vitamin C only on serum levels of cell adhesion molecules and C-reactive protein in patients with chronic degenerative AS, with or without concomitant coronary artery disease.

Methods and results: One hundred patients with asymptomatic or mildly symptomatic moderate AS were randomized in 2:2:1 format in an open-label trial. Forty-one patients received vitamin E (400 IU) and vitamin C (1000 mg) daily, 39 patients received vitamin C (1000 mg) only, and 20 patients were followed as controls. Serum intracellular adhesion molecule (ICAM-1), E selectin, P selectin, vascular-cellular adhesion molecule (VCAM-1), C-reactive protein, and alpha-tocopherol (vitamin E) were measured by enzyme-linked immunosorbent assay at baseline and 6 months postsupplementation. Half of the patients from each of the 2 active groups were followed for further 6 months to determine any changes after cessation of therapy. In the vitamin E and C, group there was reduction in serum ICAM-1 (298 +/- 12 to 272 +/- 12 ng/mL at 6 months, P = .0015) with a return to base line 6 months after cessation of therapy. In the vitamin C only group, there was a reduction in serum P selectin (134 +/- 10 to 118 +/- 10 ng/mL at 6 months, P = .033). All the inflammatory markers were unchanged in control group over 6 months of follow-up.

Conclusion: Vitamin E and C supplementation had modest anti-inflammatory effect in chronic degenerative AS. The clinical relevance of this would require further clarification.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / blood
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology*
  • Antioxidants / pharmacology*
  • Antioxidants / therapeutic use
  • Aortic Valve Stenosis / blood*
  • Aortic Valve Stenosis / drug therapy
  • Aortic Valve Stenosis / pathology
  • Ascorbic Acid / pharmacology*
  • Ascorbic Acid / therapeutic use
  • C-Reactive Protein / analysis
  • Cell Adhesion Molecules / blood*
  • Drug Therapy, Combination
  • E-Selectin / blood
  • Female
  • Humans
  • Inflammation
  • Intercellular Adhesion Molecule-1 / blood
  • Male
  • Middle Aged
  • P-Selectin / blood
  • Treatment Outcome
  • Vascular Cell Adhesion Molecule-1 / blood
  • Vitamin E / blood
  • Vitamin E / pharmacology*
  • Vitamin E / therapeutic use

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antioxidants
  • Cell Adhesion Molecules
  • E-Selectin
  • P-Selectin
  • Vascular Cell Adhesion Molecule-1
  • Intercellular Adhesion Molecule-1
  • Vitamin E
  • C-Reactive Protein
  • Ascorbic Acid