Coronary Heart Disease
Serial coronary angiographic evidence that antioxidant vitamin intake
reduces progression of coronary artery atherosclerosis.
Hodis HN; Mack WJ; La Bree L; Cashin-Hemphill L; Sevanian A; Johnson
R; Azen SP
JAMA 1995 Jun 21;273(23):1849-54
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.
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