Effects of vitamins C and E on the outcome after acute myocardial infarction in diabetics: a retrospective, hypothesis-generating analysis from the MIVIT study.
BACKGROUND
There is significant evidence that reactive oxygen species play an important role in endothelial dysfunction, ischemia/reperfusion injury as well as in the pathogenesis of diabetes mellitus (DM). It is also known that vitamins C and E have substantial antioxidant properties. However, clinical evidence concerning this topic is insufficient so far. The aim of the present study was to determine if the administration of vitamins C and E influences the outcome in diabetic patients with acute myocardial infarction (AMI).


METHODS
Among 800 patients with AMI included in the MIVIT (Myocardial Infarction and Vitamins) study, 122 patients (15%) had confirmed DM. A retrospective analysis of the influence of vitamins C and E on 30-day cardiac mortality in patients with or without DM was performed.


RESULTS
There was a significant reduction in 30-day cardiac mortality in diabetic patients treated with antioxidant vitamins C and E [5 (8%) vs. 14 (22%); OR 0.32, 95% CI 0.11-0.93; p = 0.036]. Such an effect has not been observed in patients without DM [19 (6%) vs. 19 (6%); OR 0.97, 95% CI 0.51-1.85; p = 0.94].


CONCLUSIONS
The results suggest that early administration of antioxidant vitamins C and E in patients with AMI and concomitant DM reduces cardiac mortality.
Jaxa-Chamiec
Tomasz
T
Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland. tomjch@kkcmkp.pl
Bednarz
Bronislaw
B
Herbaczynska-Cedro
Krystyna
K
Maciejewski
Pawel
P
Ceremuzynski
Leszek
L
D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage*; D003920:Diabetes Mellitus / Q000378:metabolism / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality*; D018384:Oxidative Stress / Q000187:drug effects; D010865:Pilot Projects; D016032:Randomized Controlled Trials as Topic; D017382:Reactive Oxygen Species / Q000378:metabolism; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014810:Vitamin E / Q000008:administration & dosage*
D000975:Antioxidants; D017382:Reactive Oxygen Species; D014810:Vitamin E; D001205:Ascorbic Acid