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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24:136.)
© 2004 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Vitamin E Supplementation in Patients With Carotid Atherosclerosis

Reversal of Altered Oxidative Stress Status in Plasma but not in Plaque

Fausta Micheletta; Silvia Natoli; Maria Misuraca; Enrico Sbarigia; Ulf Diczfalusy; Luigi Iuliano

From the Dipartimento di Medicina Interna (F.M., S.N., L.I.) e di Scienze Chirurgiche (M.M., E.S.), University La Sapienza, Rome, Italy; and Department of Laboratory Medicine, Karolinska Institutet, Huddinge University Hospital (U.D.), Sweden.

Correspondence to Luigi Iuliano, MD, Dipartimento di Medicina Interna, Università La Sapienza, Via del Policlinico, 155. 00161 Rome, Italy. E-mail luigi.iuliano{at}uniroma1.it

Objective— Oxidative stress is believed to play a pivotal role in the initiation and progression of atherosclerosis. We analyzed whether vitamin E supplementation influences oxidative stress in plasma and atherosclerotic plaques of patients with severe atherosclerosis.

Methods and Results— In 16 patients who were candidates for carotid endarterectomy and in 32 age- and sex-matched controls, plasma levels of 7ß-hydroxycholesterol, 7-ketocholesterol, cholesterol, and vitamin E were measured. Patients were randomly allocated to standard treatment with or without 900 mg/d vitamin E. After 6 weeks of treatment, the reported variables were measured in plasma and plaques. The plasma vitamin E/cholesterol ratio was significantly lower in patients than in controls (3.05±0.6 versus 6.3±1.7 µmol/mmol cholesterol, P<0.001). Plasma 7ß-hydroxycholesterol was significantly higher in patients than in controls (5.0±1.04 versus 4.4±0.6 ng/mL, P<0.05). Patients who were given vitamin E supplementation showed a significant increase of plasma vitamin E with concomitant decrease of 7ß-hydroxycholesterol. Conversely, no treatment dependence was observed in oxysterol or vitamin E content of plaques.

Conclusions— An imbalance between oxidative stress and antioxidant status is present in patients with advanced atherosclerosis. Vitamin E supplementation improves this imbalance in plasma but not in plaques.

Key Words: atherosclerosis • oxidative stress • vitamin E • oxysterols • carotid plaques

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