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Vitamin E for coronary bypass operations. A prospective, double-blind, randomized trial
T M Yau1, R D Weisel, D A Mickle
1Department of Clinical Biochemistry, Toronto Hospital, Ontario, Canada.
The Journal of Thoracic and Cardiovascular Surgery
|August 1, 1994
Summary
Vitamin E (alpha-tocopherol) supplementation improved heart function and metabolism after coronary bypass surgery. This antioxidant treatment led to better cardiac performance and reduced injury markers in patients.
Area of Science:
- Cardiology
- Biochemistry
- Pharmacology
Background:
- Free radical lipid peroxidation negatively impacts metabolism and ventricular function post-cardiac surgery.
- Antioxidants show potential for enhancing metabolic and functional recovery after cardiac operations.
Purpose of the Study:
- To evaluate the effects of vitamin E (alpha-tocopherol) on myocardial metabolism and ventricular function in patients undergoing elective coronary bypass operations.
- To assess if alpha-tocopherol supplementation can mitigate post-operative cardiac dysfunction.
Main Methods:
- A prospective, randomized, double-blind clinical trial involving 28 patients undergoing coronary bypass surgery.
- Patients received either RRR-alpha-tocopheryl acetate (vitamin E) or a corn oil placebo.
- Myocardial metabolism and ventricular function were assessed, with vitamin E confirming doubled myocardial alpha-tocopherol levels.
Main Results:
- Alpha-tocopherol treatment resulted in myocardial lactate consumption versus production in controls during bypass.
- Improved left ventricular stroke work indices and diastolic compliance were observed in the vitamin E group post-operation.
- Lower levels of postoperative creatine kinase cardiac isoenzyme were found in patients treated with alpha-tocopherol.
Conclusions:
- Pretreatment with alpha-tocopherol, achieving doubled myocardial concentrations, demonstrated a modest but significant improvement in metabolic and functional outcomes after coronary bypass.
- While not recommended for low-risk patients, these findings support further investigation of alpha-tocopherol in high-risk patient populations.