Vitamin E May Reduce Risk During Coronary Bypass Surgery

BACKGROUND: "Ischemia-reperfusion" injury commonly occurs during coronary artery bypass surgery, when blood flow to the heart is interrupted (ischemia) and later resumed (reperfusion). The cause is believed to be related to the formation of large numbers of free radicals. Some studies have shown that supplemental antioxidants can reduce the extent of ischemia-reperfusion injury, likely by quenching free radicals.

RESEARCH: In this study, researchers sprayed water soluble vitamin E (which was in a saline solution) or a saline solution alone into coronary arteries during heart surgery. Fourteen patients received vitamin E (100 mg) and 16 received only saline solution. Several markers of arterial injury were measured in the patients, and these markers included cardiac troponin-1, creatine kinase, and lactate.

RESULTS: Patients receiving the vitamin E had lower levels of the markers for heart damage after reperfusion, indicating less ischemia-reperfusion injury. Levels of cardiac troponin-1 were about 56 percent lower and creatine kinase levels were about 43 percent lower 8 hours after reperfusion in the vitamin E group than in the placebo group. Coronary sinus lactate levels were about 33 percent lower 1 hour after reperfusion in the vitamin E group.

IMPLICATIONS: This study found that a spray of vitamin E inside arteries during bypass surgery reduced the extent of injury to heart cells. Although the study was relatively small, it suggests a novel use for vitamin E.

Canbaz S, Duran E, Ege T, et al, "The effects of intracoronary administration of vitamin E on myocardial ischemia-reperfusion injury during coronary artery surgery," Thoracic and Cardiovascular Surgeon, 2003; 51:57-61.

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