Cholesterol-adjusted vitamin E serum levels are associated with cardiovascular events in patients with non-valvular atrial fibrillation

被引:13
作者
Cangemi, Roberto [1 ]
Pignatelli, Pasquale [1 ]
Carnevale, Roberto [1 ]
Corazza, Gino Roberto [2 ]
Pastori, Daniele [1 ]
Farcomeni, Alessio [3 ]
Basili, Stefania [1 ]
Davi, Giovanni [4 ]
Ferro, Domenico [1 ]
Hiatt, William R. [5 ,6 ]
Licata, Giuseppe [7 ]
Lip, Gregory Y. H. [8 ]
Loffredo, Lorenzo [1 ]
Mannucci, Pier Mannuccio [9 ]
Vestri, Annarita [3 ]
Violi, Francesco [1 ]
机构
[1] Univ Roma La Sapienza, Clin Med 1, Atherothrombosis Ctr, I-00161 Rome, Italy
[2] Univ Pavia, Fdn IRCCS Policlin San Matteo, I-27100 Pavia, Italy
[3] Univ Roma La Sapienza, Dept Sci Publ Hlth & Infect Dis, I-00161 Rome, Italy
[4] Univ G dAnnunzio, Ctr Excellence Aging, Chieti, Italy
[5] Univ Colorado, Sch Med, Div Cardiol, Aurora, CO USA
[6] CPC Clin Res, Aurora, CO USA
[7] Univ Palermo, Dipartimento Biomed Med Interna & Specialist, Palermo, Italy
[8] Univ Birmingham, City Hosp, Ctr Cardiovasc Sci, Birmingham, W Midlands, England
[9] IRCCS Ca Granda Maggiore Policlin Hosp Fdn, Milan, Italy
关键词
Atrial fibrillation; Cardiovascular events; Vitamin E; C-REACTIVE PROTEIN; E SUPPLEMENTATION; VENOUS THROMBOEMBOLISM; ORAL ANTICOAGULATION; RANDOM ALLOCATION; ALPHA-TOCOPHEROL; VASCULAR EVENTS; WOMENS-HEALTH; RISK-FACTORS; STROKE;
D O I
10.1016/j.ijcard.2013.04.142
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Non-valvular atrial fibrillation is associated with an increase in thromboembolism, i.e. stroke, and atherosclerotic events, i.e. myocardial infarction. Vitamin E possesses anti-coagulant as well as anti-atherosclerotic properties. Our aim was to assess whether vitamin E is associated with cardiovascular events in patients with non-valvular atrial fibrillation. Methods: Serum levels of cholesterol-adjusted vitamin E were measured in 1012 patients with non-valvular atrial fibrillation. Patients were followed for a mean time of 27.0 months, and cardiovascular events, such as cardiovascular death and fatal and nonfatal stroke or myocardial infarction, were recorded. Results: During the follow-up period, cardiovascular events occurred in 109 (11%) patients (18 fatal and 14 nonfatal myocardial infarction; 13 fatal and 19 nonfatal ischemic strokes; 45 cardiovascular deaths). Lower vitamin E serum levels were found in patients who experienced cardiovascular events compared to those who did not (3.8 +/- 1.2 vs. 4.4 +/- 1.8 mu mol/mmol cholesterol; p < 0.001). Using a Cox proportional hazard model, age, diabetes, history of stroke and myocardial infarction and vitamin E serum levels (HR 0.77; 95% CI: 0.67-0.89; p = 0.001) independently predicted cardiovascular events. Patients with vitamin E < 4.2 mu mol/mmol cholesterol (median values) had an increased risk of cardiovascular events (HR 1.87; 95% CI: 1.25-2.80: p = 0.002). Conclusions: Low vitamin E serum levels are associated with an increased risk of cardiovascular events in patients with non-valvular atrial fibrillation. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:3241 / 3247
页数:7
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