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Fang等通过对接受心脏移植的病人内层指数的测量(血管区域和斑块)发现,补充抗氧化剂维生素C(500mg)和维生素E(400IU),可以减缓移植相关性冠状动脉粥样硬化的进程。
The Lancet, Volume 359, Issue 9312, Pages 1108 - 1113, 30 March 2002
Effect of vitamins C and E on progression of transplant-associated arteriosclerosis: a randomised trial
Dr James C Fang, Scott Kinlay, John Beltrame, Hiroyuki Hikiti, Marco Wainstein, Dominik Behrendt, Jung Suh, Balz Frei, Gilbert H Mudge, Andrew P Selwyn, Peter Ganz
Summary
Background
Cardiac transplantation is associated with oxidant stress, which may contribute to the development of accelerated coronary arteriosclerosis. We postulated that treatment with antioxidant vitamins C and E would retard the progression of transplant-associated arteriosclerosis.
Methods
In a double-blind prospective study, 40 patients (0—2 years after cardiac transplantation) were randomly assigned vitamin C 500 mg plus vitamin E 400 IU, each twice daily (n=19), or placebo (n=21) for 1 year. The primary endpoint was the change in average intimal index (plaque area divided by vessel area) measured by intravascular ultrasonography (IVUS). Coronary endothelium-dependent vasoreactivity was assessed with intracoronary acetylcholine infusions. IVUS, coronary vasoreactivity, and vitamin C and E plasma concentrations were assessed at baseline and at 1 year follow-up. All patients received pravastatin. Analyses were by intention to treat.
Findings
Vitamin C and E concentrations increased in the vitamin group (vitamin C 43 [SD 21] to 103 [43] μmol/L; vitamin E 24 [14] to 65 [27] μmol/L) but did not change in the placebo group (vitamin C 45 [15] vs 43 [16] μmol/L; vitamin E 27 [14] vs 27 [9] μmol/L; p< 0·0001 for difference between groups). During 1 year of treatment, the intimal index increased in the placebo group by 8% (SE 2) but did not change significantly in the treatment group (0·8% [1]; p=0·008). Coronary endothelial function remained stable in both groups.
Interpretation
Supplementation with antioxidant vitamins C and E retards the early progression of transplant-associated coronary arteriosclerosis.
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