title: Antioxidants in adipose tissue and risk of myocardial infarction: the EURAMIC Study.
abstract: Laboratory and epidemiological studies suggest that the antioxidants, vitamin E and beta-carotene, protect against coronary heart disease. In a European multicentre case-control study alpha-tocopherol and beta-carotene concentrations were measured in adipose-tissue samples collected in 1991-92 from 683 people with acute myocardial infarction and 727 controls. Mean adipose-tissue beta-carotene concentration was 0.35 microgram/g in cases and 0.42 in controls, with age-adjusted and centre-adjusted mean difference 0.07 microgram/g (95% confidence interval [CI] 0.04-0.10). Mean alpha-tocopherol concentrations were 193 micrograms/g and 192 micrograms/g for cases and controls, respectively. The age-adjusted and centre-adjusted odds ratio for risk of myocardial infarction in the lowest quintile of beta-carotene as compared with the highest was 2.62 (95% CI 1.79-3.83). Additional control for body-mass index and smoking reduced the odds ratio to 1.78 (95% CI 1.17-2.71); other established risk factors did not substantially alter this ratio. The increased risk was mainly confined to current smokers: the multivariate odds ratio in the lowest beta-carotene quintile in smokers was 2.39 (95% CI 1.35-4.25), whereas it was 1.07 for people who had never smoked. A low alpha-tocopherol concentration was not associated with risk of myocardial infarction. Our results support the hypothesis that high beta-carotene concentrations within the normal range reduce the risk of a first myocardial infarction. The findings for alpha-tocopherol are compatible with previous observations of reduced risk among vitamin E supplement users only. The consumption of beta-carotene-rich foods such as carrots and green-leaf vegetables may reduce the risk of myocardial infarction.
authors.affiliation: EURAMIC (European community multicenter study on antioxidants, myocardial Infarction, and breast cancer) coordinating centre, TNO Toxicology and Nutrition Institute, Zelst, Netherlands.
authors.forename: A F
authors.initials: AF
authors.lastname: Kardinaal
authors.forename: F J
authors.initials: FJ
authors.lastname: Kok
authors.forename: J
authors.initials: J
authors.lastname: Ringstad
authors.forename: J
authors.initials: J
authors.lastname: Gomez-Aracena
authors.forename: V P
authors.initials: VP
authors.lastname: Mazaev
authors.forename: L
authors.initials: L
authors.lastname: Kohlmeier
authors.forename: B C
authors.initials: BC
authors.lastname: Martin
authors.forename: A
authors.initials: A
authors.lastname: Aro
authors.forename: J D
authors.initials: JD
authors.lastname: Kark
authors.forename: M
authors.initials: M
authors.lastname: Delgado-Rodriguez
mesh_terms: D000273:Adipose Tissue / Q000737:chemistry*; D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000032:analysis*; D002338:Carotenoids / Q000032:analysis*; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000503:physiopathology; D016017:Odds Ratio; D012307:Risk Factors; D014810:Vitamin E / Q000032:analysis*; D019207:beta Carotene
chemical_list: D000975:Antioxidants; D019207:beta Carotene; D014810:Vitamin E; D002338:Carotenoids