title: Cholesterol-adjusted vitamin E serum levels are associated with cardiovascular events in patients with non-valvular atrial fibrillation.
abstract: BACKGROUND
  Non-valvular atrial fibrillation is associated with an increase in thromboembolism, i.e. stroke, and atherosclerotic events, i.e. myocardial infarction. Vitamin E possesses anti-coagulant as well as anti-atherosclerotic properties. Our aim was to assess whether vitamin E is associated with cardiovascular events in patients with non-valvular atrial fibrillation.
  
  
  METHODS
  Serum levels of cholesterol-adjusted vitamin E were measured in 1012 patients with non-valvular atrial fibrillation. Patients were followed for a mean time of 27.0 months, and cardiovascular events, such as cardiovascular death and fatal and nonfatal stroke or myocardial infarction, were recorded.
  
  
  RESULTS
  During the follow-up period, cardiovascular events occurred in 109 (11%) patients (18 fatal and 14 nonfatal myocardial infarction; 13 fatal and 19 nonfatal ischemic strokes; 45 cardiovascular deaths). Lower vitamin E serum levels were found in patients who experienced cardiovascular events compared to those who did not (3.8±1.2 vs. 4.4±1.8 μmol/mmol cholesterol; p<0.001). Using a Cox proportional hazard model, age, diabetes, history of stroke and myocardial infarction and vitamin E serum levels (HR 0.77; 95% CI: 0.67-0.89; p=0.001) independently predicted cardiovascular events. Patients with vitamin E<4.2 μmol/mmol cholesterol (median values) had an increased risk of cardiovascular events (HR 1.87; 95% CI: 1.25-2.80: p=0.002).
  
  
  CONCLUSIONS
  Low vitamin E serum levels are associated with an increased risk of cardiovascular events in patients with non-valvular atrial fibrillation.
authors: I Clinica Medica, Atherothrombosis Center, "Sapienza" University of Rome, Rome, Italy.
authors: Roberto
authors: R
authors: Cangemi
authors: Pasquale
authors: P
authors: Pignatelli
authors: Roberto
authors: R
authors: Carnevale
authors: Gino Roberto
authors: GR
authors: Corazza
authors: Daniele
authors: D
authors: Pastori
authors: Alessio
authors: A
authors: Farcomeni
authors: Stefania
authors: S
authors: Basili
authors: Giovanni
authors: G
authors: Davì
authors: Domenico
authors: D
authors: Ferro
authors: William R
authors: WR
authors: Hiatt
authors: Giuseppe
authors: G
authors: Licata
authors: Gregory Y H
authors: GY
authors: Lip
authors: Lorenzo
authors: L
authors: Loffredo
authors: Pier Mannuccio
authors: PM
authors: Mannucci
authors: Annarita
authors: A
authors: Vestri
authors: Francesco
authors: F
authors: Violi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D002784:Cholesterol / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014810:Vitamin E / Q000097:blood*
chemical_list: D015415:Biomarkers; D014810:Vitamin E; D002784:Cholesterol
keywords: Atrial fibrillation; Cardiovascular events; Vitamin E