维生素C和E对糖尿病患者急性心肌梗死后结局的影响：来自MIVIT研究的一项回顾性、假设生成分析

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

作者信息

Jaxa-Chamiec Tomasz, Bednarz Bronislaw, Herbaczynska-Cedro Krystyna, Maciejewski Pawel, Ceremuzynski Leszek

机构信息

Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.

出版信息

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

DOI:10.1159/000151239

PMID:18698138

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.

摘要

背景

有大量证据表明活性氧在血管内皮功能障碍、缺血/再灌注损伤以及糖尿病（DM）发病机制中起重要作用。还已知维生素C和E具有显著的抗氧化特性。然而，迄今为止关于该主题的临床证据尚不充分。本研究的目的是确定给予维生素C和E是否会影响急性心肌梗死（AMI）糖尿病患者的预后。

方法

在纳入心肌梗死与维生素（MIVIT）研究的800例AMI患者中，122例（15%）确诊为DM。对维生素C和E对有或无DM患者30天心脏死亡率的影响进行回顾性分析。

结果

接受抗氧化维生素C和E治疗的糖尿病患者30天心脏死亡率显著降低[5例（8%）对14例（22%）；比值比0.32，95%可信区间0.11 - 0.93；p = 0.036]。在无DM患者中未观察到这种效果[19例（6%）对19例（6%）；比值比0.97，95%可信区间0.51 - 1.85；p = 0.94]。