Effects of vitamins C and E on the outcome after acute myocardial infarction in diabetics: a retrospective, hypothesis-generating analysis from the MIVIT study

Cardiology. 2009;112(3):219-23. doi: 10.1159/000151239. Epub 2008 Aug 12.

Abstract

Background: There is significant evidence that reactive oxygen species play an important role in endothelial dysfunction, ischemia/reperfusion injury as well as in the pathogenesis of diabetes mellitus (DM). It is also known that vitamins C and E have substantial antioxidant properties. However, clinical evidence concerning this topic is insufficient so far. The aim of the present study was to determine if the administration of vitamins C and E influences the outcome in diabetic patients with acute myocardial infarction (AMI).

Methods: Among 800 patients with AMI included in the MIVIT (Myocardial Infarction and Vitamins) study, 122 patients (15%) had confirmed DM. A retrospective analysis of the influence of vitamins C and E on 30-day cardiac mortality in patients with or without DM was performed.

Results: There was a significant reduction in 30-day cardiac mortality in diabetic patients treated with antioxidant vitamins C and E [5 (8%) vs. 14 (22%); OR 0.32, 95% CI 0.11-0.93; p = 0.036]. Such an effect has not been observed in patients without DM [19 (6%) vs. 19 (6%); OR 0.97, 95% CI 0.51-1.85; p = 0.94].

Conclusion: The results suggest that early administration of antioxidant vitamins C and E in patients with AMI and concomitant DM reduces cardiac mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antioxidants / administration & dosage*
  • Ascorbic Acid / administration & dosage*
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / mortality*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / drug therapy*
  • Myocardial Infarction / metabolism
  • Myocardial Infarction / mortality*
  • Oxidative Stress / drug effects
  • Pilot Projects
  • Randomized Controlled Trials as Topic
  • Reactive Oxygen Species / metabolism
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Vitamin E / administration & dosage*

Substances

  • Antioxidants
  • Reactive Oxygen Species
  • Vitamin E
  • Ascorbic Acid