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American Journal of Clinical Nutrition, Vol. 86, No. 5, 1392-1398, November 2007
© 2007 American Society for Nutrition

ORIGINAL RESEARCH COMMUNICATION

Effect of high-dose {alpha}-tocopherol supplementation on biomarkers of oxidative stress and inflammation and carotid atherosclerosis in patients with coronary artery disease1,2,3

Sridevi Devaraj, Rong Tang, Beverley Adams-Huet, Andrea Harris, Thanalakshmi Seenivasan, James A de Lemos and Ishwarlal Jialal

1 From the University of Texas Southwestern Medical Center, Dallas, TX (BA-H, TS, AH, and JAdeL); University of California Davis Medical Center, Sacramento, CA (SD and IJ); and Wake Forest University, Winston-Salem, NC (RT)

Background: Oxidative stress and inflammation are crucial in atherogenesis. {alpha}-Tocopherol is both an antioxidant and an antiinflammatory agent.

Objective: We evaluated the effect of RRR-{alpha}-tocopherol supplementation on carotid atherosclerosis in patients with stable coronary artery disease (CAD) on drug therapy.

Design: Randomized, controlled, double-blind trial compared RRR-{alpha}-tocopherol (1200 IU/d for 2 y) with placebo in 90 patients with CAD. Intimal medial thickness (IMT) of both carotid arteries was measured by high-resolution B-mode ultrasonography at 0, 1, 1.5, and 2 y. At 6-mo intervals, plasma {alpha}-tocopherol concentrations, C-reactive protein (CRP), LDL oxidation, monocyte function (superoxide anion release, cytokine release, and adhesion to endothelium), and urinary F2-isoprostanes were measured.

Results: {alpha}-Tocopherol concentrations were significantly higher in the {alpha}-tocopherol group but not in the placebo group. High-sensitivity CRP concentrations were significantly lowered with {alpha}-tocopherol supplementation than with placebo (32%; P < 0.001). {alpha}-Tocopherol supplementation significantly reduced urinary F2-isoprostanes (P < 0.001) and monocyte superoxide anion and tumor necrosis factor release compared with baseline and placebo (P < 0.001). No significant difference was observed in the mean change in total carotid IMT in the placebo and {alpha}-tocopherol groups. In addition, no significant difference in cardiovascular events was observed (P = 0.21).

Conclusions: High-dose RRR-{alpha}-tocopherol supplementation in patients with CAD was safe and significantly reduced plasma biomarkers of oxidative stress and inflammation but had no significant effect on carotid IMT during 2 y.

Key Words: Vitamin E • atherosclerosis • coronary artery disease • inflammation • oxidative stress • intimal media thickness • carotid






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