Vitamin E for coronary bypass operations

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 108; no. 2; pp. 302 - 310
• Main Authors: Yau, Terrence M., Weisel, Richard D., Mickle, Donald A.G., Burton, Graham W., Ingold, Keith U., Ivanov, Joan, Mohabeer, Molly K., Tumiati, Laura, Carson, Susan
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.08.1994
• ISSN: 0022-5223; 1097-685X
• DOI: 10.1016/S0022-5223(94)70012-5

Background: Free radical lipid peroxidation contributes to the abnormal metabolism and ventricular function frequently seen after cardiac operations. Antioxidants may improve metabolic and functional recovery. Methods: A prospective, randomized, double-blind clinical trial was conducted to determine the effects of vitamin E (alpha-tocopherol) (n = 14) or a corn oil placebo (n = 14) in patients undergoing elective coronary bypass operations. The RRR-alpha-tocopheryl acetate doubled the alpha-tocopherol levels in the heart. Myocardial metabolism and ventricular function were assessed after the operation. Results: Atrial pacing induced myocardial lactate production in the control patients but lactate consumption in the alpha-tocopherol–treated patients on bypass 25 minutes after crossclamp release. Left ventricular stroke work indices were higher, at similar ventricular volumes, in the alpha-tocopherol–treated group, which indicates improved preload recruitable stroke work, and diastolic compliance was greater 4 hours after the operation. The postoperative creatine kinase cardiac isoenzyme levels were lower in the patients who received alpha-tocopherol. Conclusions: Pretreatment with alpha-tocopherol sufficient to double the myocardial concentrations had a small but significant metabolic and functional effect after elective coronary bypass operations when compared with placebo. These results do not justify pretreatment of low-risk patients, but they do justify an evaluation in high-risk patients. (J THORAC CARDIOVASC SURG 1994;108:302-10)