Abstract
BackgroundAntioxidant vitamin (vitamin E, beta-carotene, and vitamin C) are widely used for preventing major cardiovascular outcomes. However, the effect of antioxidant vitamin on cardiovascular events remains unclear.Methodology and Principal FindingsWe searched PubMed, EmBase, the Cochrane Central Register of Controlled Trials, and the proceedings of major conferences for relevant literature. Eligible studies were randomized controlled trials that reported on the effects of antioxidant vitamin on cardiovascular outcomes as compared to placebo. Outcomes analyzed were major cardiovascular events, myocardial infarction, stroke, cardiac death, total death, and any possible adverse events. We used the I2 statistic to measure heterogeneity between trials and calculated risk estimates for cardiovascular outcomes with random-effect meta-analysis. Independent extraction was performed by two reviewers and consensus was reached. Of 293 identified studies, we included 15 trials reporting data on 188209 participants. These studies reported 12749 major cardiovascular events, 6699 myocardial infarction, 3749 strokes, 14122 total death, and 5980 cardiac deaths. Overall, antioxidant vitamin supplementation as compared to placebo had no effect on major cardiovascular events (RR, 1.00; 95%CI, 0.96–1.03), myocardial infarction (RR, 0.98; 95%CI, 0.92–1.04), stroke (RR, 0.99; 95%CI, 0.93–1.05), total death (RR, 1.03; 95%CI, 0.98–1.07), cardiac death (RR, 1.02; 95%CI, 0.97–1.07), revascularization (RR, 1.00; 95%CI, 0.95–1.05), total CHD (RR, 0.96; 95%CI, 0.87–1.05), angina (RR, 0.98; 95%CI, 0.90–1.07), and congestive heart failure (RR, 1.07; 95%CI, 0.96 to 1.19).Conclusion/SignificanceAntioxidant vitamin supplementation has no effect on the incidence of major cardiovascular events, myocardial infarction, stroke, total death, and cardiac death.
Highlights
Cardiovascular disease is the leading cause of premature morbidity and mortality worldwide for both men and women [1,2]
The results of our study suggested that antioxidant vitamin supplementation does not effect on major cardiovascular events, myocardial infarction, stroke, total death, cardiac death, revascularization, coronary heart disease, angina, and congestive heart failure
There were no significant differences between antioxidant vitamin supplementation and placebo in the relative risk for major cardiovascular outcomes
Summary
Cardiovascular disease is the leading cause of premature morbidity and mortality worldwide for both men and women [1,2]. It has been suggested that raised concentrations of antioxidant vitamin in the blood should be as a therapeutic approach to prevent cardiovascular disease [6,7,8]. Antioxidant vitamins (vitamin E, beta-carotene, and vitamin C) are clearly effective at raising concentration of plasma antioxidant vitamin [10,11]. Most randomized controlled trials evaluated the effects of combination of vitamins on the risk of major cardiovascular outcomes. Their effects on cardiovascular outcomes remain unclear. Antioxidant vitamin (vitamin E, beta-carotene, and vitamin C) are widely used for preventing major cardiovascular outcomes. The effect of antioxidant vitamin on cardiovascular events remains unclear
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