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Skip Navigation LinksHome > May 2006 - Volume 7 - Issue 5 > Vitamin E
increases the risk of developing heart failure aft...
< Previous Abstract  Next Abstract > Text sizing:A A A Journal of
Cardiovascular Medicine: May 2006 - Volume 7 - Issue 5 - p 347-350
doi: 10.2459/01.JCM.0000223257.09062.17Original articles

Vitamin E increases the risk of developing heart failure after
myocardial infarction: results from the GISSI-Prevenzione trial
---------------------------------------------------------------
Marchioli, Roberto; Levantesi, Giacomo; Macchia, Alejandro; Marfisi,
Rosa Maria; Nicolosi, Gian Luigi; Tavazzi, Luigi; Tognoni, Gianni;
Valagussa, Franco; on behalf of the GISSI-Prevenzione Investigators

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Abstract

Objective: Although results from basic science suggested a protective
role of vitamin E treatment in the prevention of cardiovascular
disease, recent evidence indicates increased cardiovascular mortality
due to vitamin E treatment. Recently, the HOPE trial showed an
increment of the incidence of congestive heart failure (CHF) in
patients treated with vitamin E.
Methods: We explored the effect of vitamin E on development of CHF in
8415 postinfarction patients without CHF at baseline, with an
echocardiographic measure of left ventricular ejection fraction, who
have been followed up for 3.5 years in the GISSI-Prevenzione trial.
CHF during follow-up was defined as hospitalization or death for CHF.
Cox regression models adjusted for relevant prognostic indicators were
fitted.

Results: Main clinical characteristics were balanced in the 4202 and
4213 patients allocated vitamin E and control group, respectively.
During follow-up, 220 patients (2.6%) developed CHF. Patients
allocated vitamin E had a nonsignificant 20% (95% confidence intervals
0.92-1.56, P = 0.18) increased risk of developing CHF. Vitamin E
treatment, however, was associated with a significant 50% increase
(95% confidence intervals 1.03-2.20, P = 0.034) of CHF in patients
with left ventricular dysfunction (ejection fraction < 50%).
Conclusions: Our results confirm and extend previous evidence on the
possible harmful effect of vitamin E on ventricular function in
patients with cardiovascular disease. Available evidence should
discourage the use of vitamin E in patients with left ventricular
dysfunction.

© 2006 Italian Federation of Cardiology
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