Vitamin E increases the risk of developing heart failure after myocardial infarction: results from the GISSI-Prevenzione trial
Vitamin E increases the risk of developing heart failure after myocardial infarction: results from the GISSI-Prevenzione trial
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DOI：
10.2459/01.jcm.0000223257.09062.17
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发表时间：
2006-05-01
影响因子：
3
通讯作者：
Valagussa, Franco
中科院分区：
文献类型：
--
作者：
Marchioli, Roberto;Levantesi, Giacomo;Valagussa, Franco
虽然基础科学的结果表明维生素E治疗在预防心血管疾病方面具有保护作用，但最近的证据表明，维生素E治疗增加了心血管疾病死亡率。最近，HOPE试验显示服用维生素E的患者的充血性心力衰竭（CHF）发生率增加。方法我们通过超声心动图测量左心室射血分数，探讨了维生素E对8415例基线时无CHF的梗死后患者的CHF发展的影响，这些患者在gisi - prevenzione试验中随访了3.5年。随访期间的CHF定义为因CHF住院或死亡。对相关预后指标进行校正的Cox回归模型进行拟合。结果维生素E组和对照组分别有4202例和4213例患者的主要临床特征基本平衡。在随访期间，220名患者（2.6%）发展为CHF。服用维生素E的患者发生CHF的风险增加了20%（95%可信区间0.92-1.56,P = 0.18）。然而，维生素E治疗与左心室功能障碍（射血分数< 50%）患者的CHF显著增加50%（95%可信区间1.03-2.20,P = 0.034）相关。结论本研究结果证实并扩展了先前关于维生素E对心血管疾病患者心室功能可能有害影响的证据。现有证据不鼓励左心室功能障碍患者使用维生素E。中华心血管病杂志[J] . 6(1): 1 -3。
Objective Although results from basic science suggested a protective role of vitamin E treatment in the prevention of cardiovascular disease, recent evidence indicates increased cardiovascular mortality due to vitamin E treatment. Recently, the HOPE trial showed an increment of the incidence of congestive heart failure (CHF) in patients treated with vitamin E.Methods We explored the effect of vitamin E on development of CHF in 8415 postinfarction patients without CHF at baseline, with an echocardiographic measure of left ventricular ejection fraction, who have been followed up for 3.5 years in the GISSI-Prevenzione trial. CHF during follow-up was defined as hospitalization or death for CHF. Cox regression models adjusted for relevant prognostic indicators were fitted.Results Main clinical characteristics were balanced in the 4202 and 4213 patients allocated vitamin E and control group, respectively. During follow-up, 220 patients (2.6%) developed CHF. Patients allocated vitamin E had a nonsignificant 20% (95% confidence intervals 0.92-1.56, P = 0.18) increased risk of developing CHF. Vitamin E treatment, however, was associated with a significant 50% increase ( 95% confidence intervals 1.03-2.20, P = 0.034) of CHF in patients with left ventricular dysfunction ( ejection fraction < 50%).Conclusions Our results confirm and extend previous evidence on the possible harmful effect of vitamin E on ventricular function in patients with cardiovascular disease. Available evidence should discourage the use of vitamin E in patients with left ventricular dysfunction. J Cardiovasc Med 7: 347-350 (C) 2006 Italian Federation of Cardiology.