LACK OF AN ASSOCIATION BETWEEN SERUM VITAMIN-E AND MYOCARDIAL-INFARCTION IN A POPULATION WITH HIGH VITAMIN-E LEVELS

The antioxidant effects of vitamin E may protect low density lipoprote ins from peroxidation and thus inhibit the development of arterioscler osis. Inverse associations between vitamin E levels and coronary heart disease have been reported from cross-sectional and ecologic studies. In the population-based MONICA Augsburg cohort (2023 men, 1999 women, age 25-64 years at baseline in 1984, 93% of whom were reexamined in 1 987/88) we investigated the relationship between serum vitamin E conce ntrations and the risk of subsequent myocardial infarction (MI). Betwe en 1984 and 1991, 46 cases of fatal and non-fatal myocardial infarctio n from this cohort were recruited for a nested case-control study. Fou r controls were sampled from the cohort for each case of MI with match ing for age, sex, and total cholesterol. There were no marked differen ces between cases and their matched controls in the means of vitamin E concentrations (33.9 mumol/l vs. 32.8 mumol/l, P = 0.37) or in the me an vitamin E/total cholesterol ratios (4.89 mumol/mmol vs. 4.82 mumol/ mmol, P = 0.75). The covariate adjusted relative risk (RR) for fatal p lus non-fatal MI in the lowest tertile of vitamin E relative to the up per two tertiles was 0.72 (90% confidence interval: 0.33-1.57). Likewi se, for the lowest tertile of the ratio (vitamin E/total cholesterol) the RR was 0.81 (0.42-1.56). The association was not modified by histo ry of previous coronary heart disease, fatality of MI, temporal distan ce of MI onset from vitamin E determinations, or season. Although the limited statistical power of this study has to be considered, risk est imates appeared too low to be compatible with a substantial protective effect of vitamin E levels. We conclude, therefore, that serum vitami n E concentrations were not associated with the myocardial infarction risk and suggest that this is probably due to the high average levels of vitamin E in our study population.