Your Position: Home > Journal List > China Medicine > Paper

The effect of intravenous vitamin C infusion on short-term prognosis for patients undergoing elective percutanous coronary intervention

( views:200, downloads:0 )
Author:
ZHAO Ying-xin(Twelve Wards, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)
HU Wen-kun(Twelve Wards, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)
WANG Zhi-jian(Twelve Wards, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)
ZHOU Yu-jie(Twelve Wards, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)
MA Han-ying(Twelve Wards, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)
ZHANG Ou(Twelve Wards, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)
ZHANG Wei-jun(Twelve Wards, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)
Journal Title:
China Medicine
Issue:
Volume 06, Issue 10, 2011
DOI:
10.3760/cma.j.issn.1673-4777.2011.10.001
Key Word:
Percutaneous coronary intervention; Vitamin C; Oxidation; Myocardial infarction;Acute kidney injury

Abstract: Objective To explore whether antioxidant vitamin C infusion before procedure is able to affect the incidences of periprocedural myocardial injury or contrast-induced acute kidney injury(CI-AKI) in patients undergoing percutaneous coronary intervention(PCI) for cardiovascular disease. Methods In this prospective, singlecenter, randomized study, 532 patients were randomized into two groups: the study group, which received 3 g Vitamin C infusion over 6 h before PCI; control group received normal saline. The primary endpoint was PCI related myocardial infarction (MI). The secondary endpoint was CI-AKI and the post-procedure level of 8-hydroxy-2-deoxyguanosine (8-OHdG). Results After PCI, the peak levels of CK-MB and cTnI in study group were both significantly lower than those of control group. The incidence of procedure-related MI was reduced based on CM-MB or cTnI compared with control group (CM-MB: 6.8% vs 12.7%, P=0. 021; cTnI: 20. 1% vs 28.8%, P =0.020).The CI-AKI was also significantly lower in study group compared with control group(6.8% vs 12.4%, P =0.029).The post-procedure plasma value of 8-OHdG was significantly lower than that of control group. Logistic multivariate analysis showed that pre-procedure use of vitamin C was independent protective factor for both procedure-related MI and CI-AKI ( MI: OR 0. 66, 95% CI 0. 38-0. 91, P = 0.017; CI-AKI: OR 0. 64, 95% CI 0. 27-0.89, P =0.024). Conclusion In patients undergoing elective PCI, pre-procedure intravenous treatment of Vitamin C can reduce the oxidation reaction in the plasma, the injury of myocardium and the incidence of CI-AKI.

  • [1]Basili S,Tanzilli G,Mangieri E,et al.Intravenous ascorbic acid infusion improves myocardial perfusion grade during elective percutaneous coronaryintervention:relationship with oxidative stress markers.JACC Cardiovasc Interv,2010,3(2):221-229.
  • [2]Spargias K,Alexopoulos E,Kyrzopoulos S,et al.Ascorbic acid prevents contrast-mediated nephropathy in patients with renal dysfunction undergoing coronary angiographyor intervention.Circulation,2004,110 (18):2837-2842.
  • [3]全国eGFR课题协作组.MDRD方程在我国慢性肾脏病患者中的改良和评估.中华肾脏病杂志,2006,22(10):589-595.
  • [4]Heller R,Mtnscher-Paulig F,Grabner R,et al.L-Ascorbic acid potentiates nitric oxide synthesis in endothelial cells.J Biol Chem,1999,274(12):8254-8260.
  • [5]Aguirre R,May JM.Inflammation in the vascular bed:importance of vitamin C.Pharmacol Ther,2008,119(1):96-103.
  • [6]Dijkhorst-Oei LT,Stroes ES,Koomans HA,et al.Acute simultaneous stimulation of nitric oxide and oxygen radicals by angiotensin Ⅱ in humans in vivo.J Cardiovasc Pharmacol,1999,33 (3):420-424.
  • [7]Watanabe H,Kakihana M,Ohtsuka S,et al.Randomized,doubleblind,placebo-controlled study of the preventive effect of supplemental oral vitamin C on attenuation of development of nitrate tolerance.J Am Coll Cardiol,1998,31 (6):1323-1329.
  • [8]Baker TA,Milstien S,Katusic ZS.Effect of vitamin C on the availability of tetrahydrobiopterin in human endothelial cells.J Cardiovasc Pharmacol,2001,37(3):333-338.
  • [9]Kuzkaya N,Weissmann N,Harrison DG,et al.Interactions of peroxynitrite,tetrahydrobiopterin,ascorbic acid,and thiols:implications for uncoupling endothelial nitric-oxide synthase.J Biol Chem,2003,278 (25):22546-22554.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn