Jaxa-Chamiec Tomasz, Bednarz Bronisław, Drozdowska Dorota, Gessek Jacek, Gniot Jacek, Janik Krzysztof, Kawka-Urbanek Teresa, Maciejewski Paweł, Ogórek Michał, Szpajer Michał
Postgraduate Medical School, Department of Cardiology, Grochowski Hospital, Warsaw.
Kardiol Pol. 2005 Apr;62(4):344-50.
There is a large body of evidence that reactive oxygen species (ROS) produced during myocardial ischemia and reperfusion play a crucial role in myocardial damage and endothelial dysfunction. The MIVIT pilot trial was designed to test the effects of antioxidant vitamins C and E on the clinical outcome of patients with AMI.
In this randomized, double-blind, multicenter trial, 800 patients (mean age 62) with AMI were randomly allocated to receive, on top of routine medication, one of two treatments: vitamin C (1000 mg/12 h infusion) followed by 1200 mg/24 h orally and vitamin E (600 mg/24 h) or matching placebo for 30 days. Primary end point (composite of in-hospital cardiac mortality, non-fatal new myocardial infarction, VT/VF/asystole, shock/pulmonary edema) occurred less frequently in patients treated with antioxidants (55 [14%] vs 75 [19%], OR 0.82 [95% CI, 0.68-1.00], p=0.048).
This randomized pilot trial shows that supplementation with antioxidant vitamins is safe and seems to positively influence the clinical outcome of patients with AMI. A larger study is warranted to provide further evidence of this promising and inexpensive regimen.
有大量证据表明，心肌缺血再灌注过程中产生的活性氧（ROS）在心肌损伤和内皮功能障碍中起关键作用。心肌梗死维生素干预试验（MIVIT）初步试验旨在测试抗氧化维生素C和E对急性心肌梗死（AMI）患者临床结局的影响。
在这项随机、双盲、多中心试验中，800例AMI患者（平均年龄62岁）在常规药物治疗基础上，被随机分配接受以下两种治疗之一：维生素C（1000mg/12小时静脉输注，随后口服1200mg/24小时）和维生素E（600mg/24小时），或匹配的安慰剂，为期30天。抗氧化剂治疗组患者的主要终点（院内心脏死亡率、非致命性新发心肌梗死、室性心动过速/心室颤动/心搏骤停、休克/肺水肿的复合终点）发生率较低（55例[14%]对75例[19%]，OR 0.82[95%CI，0.68 - 1.00]，p = 0.048）。
这项随机初步试验表明，补充抗氧化维生素是安全的，似乎对AMI患者的临床结局有积极影响。有必要进行更大规模的研究，以进一步证明这种有前景且廉价的治疗方案的有效性。
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