Alpha-tocopherol supplementation for men with existing coronary artery disease: a feasibility study.
BACKGROUND
Recent studies have suggested that alpha-tocopherol supplementation can help reduce the incidence of coronary disease. Our objectives were to determine the feasibility of providing alpha-tocopherol supplements to male veterans with existing coronary artery disease and determine its effects on alpha-tocopherol levels and the susceptibility of low-density lipoprotein (LDL) to oxidation.


METHODS
Fifty-seven percent of 138 coronary disease patients were willing to participate in a placebo-controlled trial -25% were already taking antioxidants. Thirty-nine men were randomly assigned to either 400 mg/day of alpha-tocopherol (n = 27) or placebo (n = 12). alpha-Tocopherol levels and LDL oxidation (measured by formation of thiobarbituric acid-reactive substance) were measured at baseline and at 6 months.


RESULTS
Thirty-three subjects (22 alpha-tocopherol, 11 placebo) completed the study; 3 subjects withdrew after suffering coronary disease events. Supplement compliance exceeded 90% and alpha-tocopherol was well tolerated. The alpha-tocopherol group had a significantly greater mean increase in lipid-adjusted alpha-tocopherol levels (73% vs. -4.6%, P < 0.0001), but oxidized LDL did not change significantly.


CONCLUSIONS
A secondary prevention trial among veterans would be feasible because the rates of enrollment, completion, compliance, and clinical events were high. alpha-Tocopherol supplements did not decrease the susceptibility of LDL to oxidation, suggesting that higher dosages or longer duration of supplementation may be required for secondary prevention.
Hoffman
R M
RM
Department of Medicine, Albuquerque Veterans Affairs Medical Center, University of New Mexico, Albuquerque 87131, USA. rhoffman@unm.edu
Garewal
H S
HS
D000368:Aged; D000704:Analysis of Variance; D000975:Antioxidants / Q000627:therapeutic use*; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000517:prevention & control*; D016757:Death, Sudden, Cardiac / Q000209:etiology; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D012008:Recurrence; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D014728:Veterans; D014810:Vitamin E / Q000097:blood / Q000627:therapeutic use*
D000975:Antioxidants; D008055:Lipids; D008074:Lipoproteins; D017392:Thiobarbituric Acid Reactive Substances; D014810:Vitamin E