Vitamin E modulation of C-reactive protein in smokers with acute coronary syndromes.
Acute coronary syndromes are characterized by the expression of proinflammatory cytokines such as C-reactive protein (CRP). Sustained upregulation of inflammatory markers is associated with an adverse prognosis. Vitamin E is known to have significant anti-inflammatory properties and has been associated with a reduction in cardiovascular events in some studies of high-risk patients. The mechanism of benefit remains controversial. We conducted a randomized, double-blind placebo controlled trial of vitamin E 400 IU daily for 6 months in 110 patients with acute coronary syndromes. Serum samples were collected at enrollment and at 2, 4, and 6 months. CRP, interleukin-6 and the soluble cell adhesion molecules were measured. Vitamin E levels increased significantly in the treatment group (from 31 micromol/l at baseline to 51 micromol/l, p <.0001) and were unchanged in the placebo group (32 micromol/l at baseline to 34 micromol/l, p = NS). CRP levels fell in both the vitamin E group and the placebo group over the treatment period (from 17.2 +/- 2.9 to 6.1 +/- 0.8 mg/l and from 21.5 +/- 4.9 to 5.9 +/- 0.9 mg/l, p = NS for the difference between active and placebo groups). However, vitamin E treatment was associated with significantly lower 6 month CRP levels in smokers versus smokers on placebo (4.7 +/- 0.71 mg/l vs. 8.26 +/- 1.5 mg/l, p =.02). Vitamin E reduces CRP levels in smokers with acute coronary syndromes for up to 6 months after hospitalization.
Murphy
Ross T
RT
Department of Cardiology, St. James's Hospital, Dublin, Ireland. rmurphy@sghms.ac.uk
Foley
J Brendan
JB
Tome
Marie-Teresa
MT
Mulvihill
Niall T
NT
Murphy
Anne
A
McCarroll
Nuala
N
Crean
Peter
P
Walsh
Micheal J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000096:biosynthesis / Q000378:metabolism*; D015815:Cell Adhesion Molecules; D002851:Chromatography, High Pressure Liquid; D004311:Double-Blind Method; D019040:E-Selectin / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000473:pathology; D019007:P-Selectin / Q000097:blood; D010919:Placebos; D011379:Prognosis; D012907:Smoking; D013997:Time Factors; D015854:Up-Regulation; D014810:Vitamin E / Q000502:physiology* / Q000627:therapeutic use*
D000975:Antioxidants; D015815:Cell Adhesion Molecules; D019040:E-Selectin; D019007:P-Selectin; D010919:Placebos; D018799:Intercellular Adhesion Molecule-1; D014810:Vitamin E; D002097:C-Reactive Protein