Serial Coronary Angiographic Evidence That Antioxidant Vitamin Intake Reduces Progression of Coronary Artery Atherosclerosis

JAMA. 1995 Jun 21;273(23):1849-54.

Abstract

Objective: To explore the association of supplementary and dietary vitamin E and C intake with the progression of coronary artery disease.

Design: A subgroup analysis of the on-trial antioxidant vitamin intake database acquired in the Cholesterol Lowering Atherosclerosis Study, a randomized, placebo-controlled, serial angiographic clinical trial evaluating the risk and benefit of colestipol-niacin on coronary artery disease progression.

Setting: Community- and university-based cardiac catheterization laboratories.

Subjects: A total of 156 men aged 40 to 59 years with previous coronary artery bypass graft surgery.

Intervention: Supplementary and dietary vitamin E and C intake (nonrandomized) in association with cholesterol-lowering diet and either colestipol-niacin or placebo (randomized).

Outcome: Change per subject in the percentage of vessel diameter obstructed because of stenosis (%S) determined by quantitative coronary angiography after 2 years of randomized therapy on all lesions, mild/moderate lesions (< 50%S), and severe lesions (> or = 50%S).

Results: Overall, subjects with supplementary vitamin E intake of 100 IU per day or greater demonstrated less coronary artery lesion progression than did subjects with supplementary vitamin E intake less than 100 IU per day for all lesions (P = .04) and for mild/moderate lesions (P = .01). Within the drug group, benefit of supplementary vitamin E intake was found for all lesions (P = .02) and mild/moderate lesions (P = .01). Within the placebo group, benefit of supplementary vitamin E intake was not found. No benefit was found for use of supplementary vitamin C exclusively or in conjunction with supplementary vitamin E, use of multivitamins, or increased dietary intake of vitamin E or vitamin C.

Conclusions: These results indicate an association between supplementary vitamin E intake and angiographically demonstrated reduction in coronary artery lesion progression. Verification from carefully designed, randomized, serial arterial imaging end point trials is needed.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Analysis of Variance
  • Antioxidants / administration & dosage
  • Antioxidants / pharmacology*
  • Ascorbic Acid / administration & dosage
  • Ascorbic Acid / pharmacology*
  • Colestipol / therapeutic use
  • Coronary Angiography
  • Coronary Artery Bypass
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / prevention & control*
  • Coronary Artery Disease / surgery
  • Diet, Atherogenic
  • Food, Fortified
  • Humans
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Vitamin E / administration & dosage
  • Vitamin E / pharmacology*

Substances

  • Antioxidants
  • Vitamin E
  • Colestipol
  • Ascorbic Acid