EFFECT OF PREOPERATIVE SUPPLEMENTATION WITH ALPHA-TOCOPHEROL AND ASCORBIC-ACID ON MYOCARDIAL INJURY IN PATIENTS UNDERGOING CARDIAC OPERATIONS

Augmentation of antioxidant defenses may help protect tissues against ischemia-reperfusion injury associated with operations involving cardi opulmonary bypass, In this study we examined the effect of pretreating patients with alpha-tocopherol (vitamin E) and ascorbic acid (vitamin C) or placebo on injury to the myocardium, Seventy-six subjects under going elective coronary artery bypass grafting participated in a prosp ective, double-blind, placebo-controlled randomized trial, receiving e ither placebo or both 750 IU dl-alpha-tocopherol per day for 7 to 10 d ays and 1 gm ascorbic acid 12 hours before the operation. Plasma alpha -tocopherol concentrations, raised fourfold by supplementation, fell b y 70% after the operation in the supplemented group and to negligible levels in the placebo group. There were no significant differences bet ween the groups with respect to release of creatine kinase hip isoenzy me over 72 hours, nor in the reduction of the myocardial perfusion def ect determined by thallium 201 uptake. Electrocardiography provided no evidence of a benefit from antioxidant supplementation, Thus the supp lementation regimen prevented the depletion of the primary lipid solub le antioxidant in plasma, but provided no measurable reduction in myoc ardial injury after the operation.