Review Article

Molecular Basis of Cardioprotective Effect of Antioxidant Vitamins in Myocardial Infarction

Table 1

Cardioprotective strategies using antioxidant vitamins C and E and other antioxidants in acute myocardial infarction.

Details of Study Study ResultsReferences

Vitamins C and E
Vitamin C (1000 mg/12 h infusion) followed by 1200 mg/24 h orally and vitamin E (600 mg/24 h).Randomized, double-blind, placebo-controlled, multicenter trial.800Improvement in mortality and clinical outcomes. Jaxa-Chamiec et al. (MIVIT trial) [17]
A retrospective analysis of the influence of vitamins C and E on 30-day cardiac mortality in patients with or without DM.Retrospective study from MIVIT trial.800 [122 (15%) DM]Reduction in cardiac mortality in DM patients treated. No significant differences in nondiabetic patients.Jaxa-Chamiec et al. [18]
Vitamins C and E (600 mg/24 h each) orally on the first day of AMI and lasting for 14 days. Randomized, double-blind, placebo-controlled trial.37Baseline QTd was similar in both groups. Significant decrease in exercise-induced QTd in treated group.Bednarz et al. [19]
Vitamin A (50,000 IU/24 h), vitamin C (1,000 mg/24 h), vitamin E (400 mg/24 h), and beta-carotene (25 mg/24 h)Randomized, double-blind, placebo-controlled trial.125Reduction in mean infarct size assessed by cardiac enzymes. Improved clinical outcomes.Singh et al. (the Indian experiment of infarct survival-3) [20]
Vitamins C and E, each 600 mg/24 h orally for 14 days. Randomized trial.61Less ECG alterations in treated patients.Chamiec et al. [21]

Other Antioxidants
Oral treatment with coenzyme Q10 (120 mg/24 h) for 28 days, administered within 3 days of the onset of symptoms.Randomized, double-blind, placebo-controlled trial.144Angina pectoris, total arrhythmias, and poor left ventricular function were significantly reduced.Singh et al. [22]
Oral L-carnitine (2 g/24 h) for 28 days.Randomized, double-blind, placebo-controlled trial.101Significant reduction in mean infarct size assessed by cardiac enzymes.Singh et al. [23]
High-dose N-acetylcysteine (2 × 1,200 mg/24 h) for 48 h, plus optimal hydration. Randomized, single-blind, placebo-controlled trial.251No differences in any of the end point with N-acetylcysteine or placebo.Thiele et al. [24]
30 mg edaravone intravenously before reperfusion.Randomized, placebo-controlled trial.101Significant reduction in reperfusion arrhythmia and mean infarct size assessed by cardiac enzymes.Tsujita et al. [25]
Intravenous bolus of superoxide-dismutase (10 mg/kg of body weight) followed by a 60 min infusion of 0.2 mg/kg/min before PCI.Randomized, placebo-controlled trial.120No significant differences.Flaherty et al. [26]
Allopurinol (400 mg) administered orally just after the admission (approximately 60 min before reperfusion).Randomized trial.38Slow flow in the recanalized coronary artery after PTCA occurred less frequently.Guan et al. [27]

  *AMI: acute myocardial infarction; DM: diabetes mellitus; PCI: percutaneous coronary intervention; QTd: QT dispersion in electrocardiogram; ECG: electrocardiogram; PTCA: percutaneous transluminal coronary angioplasty.