Effect of alpha-tocopherol and beta-carotene supplementation on coronary heart disease during the 6-year post-trial follow-up in the ATBC study.
OBJECTIVE
To evaluate the 6-year post-trial effects of alpha-tocopherol and beta-carotene supplementation on coronary heart disease (CHD) in the alpha-tocopherol, beta-carotene cancer prevention (ATBC) study.


RESULTS
29,133 male smokers, aged 50-69 years were randomised to receive alpha-tocopherol 50 mg, or beta-carotene 20 mg, or both, or placebo daily for 5-8 years. At the beginning of the post-trial follow-up, 23,144 men were still at risk for a first-ever major coronary event (MCE), and 1255 men with pre-trial history of myocardial infarction (MI) were at risk for MCE. Post-trial risk for MCE (n=2059) was 0.95 (95% confidence interval 0.87-1.04) among alpha-tocopherol recipients compared with non-recipients, and 1.14 (1.04-1.24) among beta-carotene recipients compared with non-recipients. The risk for non-fatal MI (n=993) was 0.96 (0.85-1.09) and 1.16 (1.03-1.32), and for fatal CHD (n=1066) 0.94 (0.83-1.06) and 1.11 (0.99-1.25), respectively. Among men with pre-trial MI no effects were observed in post-trial risk of MCE (n=257).


CONCLUSIONS
beta-Carotene seemed to increase the post-trial risk of first-ever non-fatal MI but there is no plausible mechanism to support it. Our findings do not advocate the use of alpha-tocopherol or beta-carotene supplements in prevention of CHD among male smokers.
Törnwall
Markareetta E
ME
National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheiminite 166, 00300 Helsinki, Finland.
Virtamo
Jarmo
J
Korhonen
Pasi A
PA
Virtanen
Mikko J
MJ
Taylor
Philip R
PR
Albanes
Demetrius
D
Huttunen
Jussi K
JK
D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D003327:Coronary Disease / Q000401:mortality / Q000517:prevention & control*; D019587:Dietary Supplements; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016019:Survival Analysis; D024502:alpha-Tocopherol / Q000008:administration & dosage*; D019207:beta Carotene / Q000008:administration & dosage* / Q000009:adverse effects
D000975:Antioxidants; D019207:beta Carotene; D024502:alpha-Tocopherol