Abstract
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 μmol/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 μmol/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.
Keywords
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Article info
Publication history
Published online: May 07, 2013
Accepted:
April 6,
2013
Received in revised form:
February 12,
2013
Received:
October 30,
2012
Footnotes
☆Authorship—R. Cangemi, P. Pignatelli, S. Basili, D. Ferro, R. Carnevale and F. Violi take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. G.R. Corazza, D. Pastori, and L. Loffredo researched and analyzed the data. Davì, W.R. Hiatt, G. Licata, G.Y.H. Lip, and P.M. Mannucci reviewed and edited the manuscript. A. Farcomeni and A. Vestri analyzed the data and edited the manuscript. The ARA PACIS study group researched the data.
☆☆Funding—This study was supported in part by a grant from the “Sapienza”-University of Rome (Ateneo Federato 2009 to FV).
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
