title: The effect of intravenous vitamin C infusion on periprocedural myocardial injury for patients undergoing elective percutaneous coronary intervention.
abstract: BACKGROUND
  This small study has determined the effect of vitamin C on myocardial reperfusion in patients undergoing elective percutaneous coronary intervention (PCI). This study was to explore whether antioxidant vitamin C infusion before the procedure is able to affect the incidence of periprocedural myocardial injury (PMI) in patients undergoing PCI.
  
  
  METHODS
  In this prospective single-centre randomized study, 532 patients were randomized into 2 groups: the vitamin C group, which received a 3-g vitamin C infusion within 6 hours before PCI, and a control group, which received normal saline. The primary end point was the troponin I-defined PMI, and the second end point was the creatine kinase (CK)-MB-defined PMI. Separate analyses using both end points were performed. PMI was defined as an elevation of cardiac biomarker values (CK-MB or troponin I) > 5 times the upper limit of normal (ULN), alone or associated with chest pain or ST-segment or T-wave changes.
  
  
  RESULTS
  After PCI, the incidence of PMI was reduced, whether defined by troponin or by CK-MB, compared with the control group (troponin I, 10.9% vs 18.4%; P = 0.016; CK-MB, 4.2% vs 8.6%; P = 0.035). Logistic multivariate analysis showed that preprocedure use of vitamin C is an independent predictor of PMI either defined by troponin I (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.33-0.97; P = 0.037) or by CK-MB (OR, 0.37; 95% CI, 0.14-0.99; P = 0.048).
  
  
  CONCLUSIONS
  In patients undergoing elective PCI, preprocedure intravenous treatment with vitamin C is associated with less myocardial injury.
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhi Jian
authors.initials: ZJ
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Wen Kun
authors.initials: WK
authors.lastname: Hu
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yu Yang
authors.initials: YY
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Dong Mei
authors.initials: DM
authors.lastname: Shi
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Wan Jun
authors.initials: WJ
authors.lastname: Cheng
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yong He
authors.initials: YH
authors.lastname: Guo
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. Electronic address: zyingxinmi@163.com.
authors.forename: Ying Xin
authors.initials: YX
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yu Jie
authors.initials: YJ
authors.lastname: Zhou
mesh_terms: D000975:Antioxidants / Q000008:administration & dosage; D001205:Ascorbic Acid / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D052279:Creatine Kinase, MB Form / Q000097:blood; D017558:Elective Surgical Procedures / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000000981:diagnostic imaging / Q000378:metabolism / Q000517:prevention & control*; D018384:Oxidative Stress / Q000187:drug effects*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D014336:Troponin / Q000097:blood
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D014336:Troponin; D052279:Creatine Kinase, MB Form; D001205:Ascorbic Acid