Anti-oxidant therapy for the treatment of coronary artery disease.
Coronary artery disease is the most common cause of death in developed countries. It may present in many different ways, but most frequently as a myocardial infarction, sudden death, angina or heart failure. Preventive measures in relation to coronary artery disease are particularly important because of its high incidence, high mortality and because most patients die outside hospital. Since the oxidation of low density lipoprotein cholesterol (LDL-C) is a critical early step in the process of atheroma formation, taking anti-oxidants to prevent LDL-C oxidation may prove a very effective means of reducing coronary artery disease mortality. However, the role of anti-oxidants in coronary artery disease prevention needs to be evaluated as part of an overall strategy that includes pharmacological and non-pharmacological measures, which are described in this review. In addition, a more structured and scientific approach to anti-oxidant therapy needs to be adopted. This requires that evidence for oxidative stress in a particular condition is obtained, the nature and severity determined and an appropriate anti-oxidant is administered, in an effective dose, which can be shown to correct the oxidative stress. When this is achieved, meaningful clinical trials should be possible, which will determine the place of anti-oxidant therapy for the specified condition.
Kendall
MJ
Clinical Investigation Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK. m.j.kendall@bham.ac.uk
Nuttall
SL