Abstract
Oxidative stress and inflammation are crucial in atherogenesis. High dose Alpha tocopherol (RRR-AT) supplementation has antioxidant and anti-inflammatory effects. Prospective studies with lower doses of AT on atherosclerosis have been equivocal. Thus, we tested the effect of RRR-AT supplementation(1200 IU/day for 2 years)on carotid atherosclerosis in a placebo-controlled, double blind study of 90 stable coronary artery disease patients. Intimal medial thickness (IMT) of both carotids, was determined by B-mode sonography at 0, 1, 1.5 and 2 yrs. At 6-month intervals blood was obtained for AT levels, C-reactive protein (CRP) and 24-hour urine for F2 -isoprostanes. AT levels significantly increased in the AT group (2.4-fold) but not in placebo. There was no significant difference in total or left carotid IMT between placebo and AT groups. There was a significant increase in IMT progression in Placebo with time for total and right CCA-IMT (p<0.05). Also, there was a significant decrease in IMT progression in the right CCA between placebo and AT groups over 2 years (p=0.017). HsCRP levels and F2-isoprostane levels significantly decreased with AT therapy compared to placebo (32% and 26%,p<0.01). Thus, high dose RRR-AT supplementation in CAD patients significantly reduced biomarkers of oxidative stress and inflammation, there was only a marginal benefit with regards to carotid atherosclerosis progression.
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