Vitamin C for Cardiac Protection during Percutaneous Coronary Intervention: A Systematic Review of Randomized Controlled Trials

Abstract

Percutaneous coronary intervention (PCI) is the preferred treatment for acute coronary syndrome (ACS) secondary to atherosclerotic coronary artery disease. This nonsurgical procedure is also used for selective patients with stable angina. Although the procedure is essential for restoring blood flow, reperfusion can increase oxidative stress as a side effect. We address whether intravenous infusion of vitamin C (VC) prior to PCI provides a benefit for cardioprotection. A total of eight randomized controlled trials (RCT) reported in the literature were selected from 371 publications through systematic literature searches in six electronic databases. The data of VC effect on cardiac injury biomarkers and cardiac function were extracted from these trials adding up to a total of 1185 patients. VC administration reduced cardiac injury as measured by troponin and CK-MB elevations, along with increased antioxidant reservoir, reduced reactive oxygen species (ROS) and decreased inflammatory markers. Improvement of the left ventricular ejection fraction (LVEF) and telediastolic left ventricular volume (TLVV) showed a trend but inconclusive association with VC. Intravenous infusion of VC before PCI may serve as an effective method for cardioprotection against reperfusion injury.

Joint Cardioprotective Effect of Vitamin C and Other Antioxidants against Reperfusion Injury in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

“…All of this has disallowed the drawing of definitive conclusions supporting a therapeutic use for Vit C. Nevertheless, there are some studies showing beneficial effects. Thus, Khan et al [ 9 ] carried out a systematic review of randomized controlled trials including 1185 patients selected from 371 publications reporting cardioprotective effects of Vit C during angioplasty, but also showing mixed results among the different studies. The administration of Vit C prior to PCI reduced cardiac injury biomarkers, as well as inflammatory markers and ROS formation.…”

Complex Coronary Instent Chronic Total Occlusion Lesions: Oxidative Stress, Inflammation, and Coronary Stent Lengths

“…Percutaneous coronary intervention (PCI) induces coronary injury on the endothelial cells which is related to the proinflammatory response and oxidative stress. PCI increases the levels of the inflammatory response and pathophysiological levels of oxidative stress response, which promotes the progression of coronary restenosis in patients with coronary artery disease after PCI [46,47]. Coronary atherosclerotic lesion formation is related to oxidative stress and inflammatory response.…”

Витамин С При Критических Состояниях: От Эксперимента К Клинике (Часть 2)

“…Однак лише група пацієнтів, яка отримала 2 г/добу АК, але не 10 г добу, мала клінічно важливе зниження потреби в норадреналіні протягом 48 год [7]. [63]. Внутрішньовенна доза АК в основному була від 1 до 3 г, а в двох дослідженнях досягала 56 г. При цьому у хворих зменшувалися показники оксидаційного стресу, рівні медіаторів запалення і маркерів ендотеліальної дисфункції, покращувався індекс перфузії міокарда.…”