on October 30, 2003
Published online before print October 30, 2003, doi: 10.1161/01.ATV.0000104028.07929.72
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Submitted on September 19, 2003
Accepted on October 20, 2003
Vitamin E Supplementation in Patients With Carotid Atherosclerosis. Reversal of Altered Oxidative Stress Status in Plasma But Not in Plaque
Fausta Micheletta ;
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.
* To whom correspondence should be addressed. 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 7
-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 above-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 7-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 7-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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