FROM:
European Heart Journal 1995 (Aug); 16(8): 1044–1049
Herbaczynska-Cedro K, K+osiewicz-Wasek B, Cedro K, Wasek W,
Panczenko-Kresowska B, Wartanowicz M
Medical Research Centre,
Polish Academy of Sciences,
Warsaw, Poland
Clinical studies suggest that neutrophil activation during acute
myocardial infarction (MI) aggravates tissue injury. Activated
neutrophils are an important source of oxygen free radicals
(OFR), the injurious effects of which are counteracted by
endogenous antioxidants. We have previously shown in healthy
subjects that supplementation with antioxidant vitamins C and E
suppresses OFR production by isolated neutrophils assayed by
chemiluminescence (CL). the present study, performed in patients
with acute MI aimed (1) to investigate the effect of vitamin C
and E supplementation upon neutrophil OFR production and serum
lipid peroxides, (2) to evaluate serum levels of vitamins C and E
in the course of MI. Forty–five patients with acute MI were
randomized to receive either conventional treatment plus vitamin
C and E aa 600 mg.day–1 p.o. for 14 days (VIT,n=23) or
conventional treatment only (control, n=22). All measurements
were performed on the 1st and 14th day. Neutrophil OFR production
assayed by CL decreased significantly in VIT patients (Wilcoxon
test for paired data P<0.01, Chi square test P<0.01). In the
control group, changes in OFR production were not significant.
Serum lipid peroxides (measured as TBARS) increased in controls
(P<0.05), but remained stable in VIT patients. Mean (plus or
minusSE) serum ascorbic acid and tocopherol on the 1st day were
0.43 plus or minus 0.18mg% and 3.25 plus or minus 1.32 microM.mM
–1 cholesterol, respectively, in all patients. On the 14th day in
non–supplemented patients mean tocopherol was unchanged, whereas
ascorbic acid increased significantly (0.63 plus or minus 0.24
mg%, P<0.01) suggesting that a low basal level was associated at
least in part with the acute phase of the disease. An expected
increase in serum vitamin levels occurred in VIT patients. In
conclusion, supplementation with vitamins C and E suppresses
neutrophil OFR production and lowers the marker of lipid
peroxidation in patients with MI. These effects, together with a
deficiency of antioxidant vitamins, particularly vitamin C in the early phase of the disease, support the view that supplementation with antioxidant vitamins is advisable in patients with
MI.