Effect of alpha-tocopherol and beta-carotene supplementation on coronary heart disease during the 6-year post-trial follow-up in the ATBC study

Markareetta E Törnwall ¹, Jarmo Virtamo , Pasi A Korhonen

⁰National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheiminite 166, 00300 Helsinki, Finland.

European Heart Journal +

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July 3, 2004

View abstract on PubMed

Summary

Beta-carotene supplementation may increase the risk of non-fatal myocardial infarction in male smokers. Alpha-tocopherol and beta-carotene supplements are not recommended for preventing coronary heart disease.

Area Of Science

Cardiovascular disease research
Nutritional science
Clinical trials

Background

Coronary heart disease (CHD) remains a leading cause of mortality in male smokers.
The role of antioxidant supplements, such as alpha-tocopherol and beta-carotene, in cardiovascular disease prevention is under investigation.
The Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) study provided an opportunity to assess long-term effects of these supplements.

Purpose Of The Study

To evaluate the 6-year post-trial effects of alpha-tocopherol and beta-carotene supplementation on coronary heart disease (CHD).
To determine the impact of these supplements on major coronary events and myocardial infarction in a large cohort of male smokers.

Main Methods

A randomized trial involving 29,133 male smokers aged 50-69 years.
Participants received daily supplementation of alpha-tocopherol (50 mg), beta-carotene (20 mg), both, or placebo for 5-8 years.
Post-trial follow-up assessed major coronary events, non-fatal myocardial infarction, and fatal CHD.

Main Results

Post-trial risk for major coronary events was similar for alpha-tocopherol recipients (0.95) but increased for beta-carotene recipients (1.14) compared to placebo.
Beta-carotene supplementation was associated with an increased risk of non-fatal myocardial infarction (1.16).
No significant effects on post-trial coronary event risk were observed in men with a pre-trial history of myocardial infarction.

Conclusions

Beta-carotene supplementation may be associated with an increased post-trial risk of non-fatal myocardial infarction in male smokers.
Alpha-tocopherol and beta-carotene supplements are not recommended for the prevention of CHD in this population.
Further research is needed to understand the mechanisms behind these observed effects.

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